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Approach to the patient with neutrophilia

Thomas D Coates, MD
Section Editors
Donald H Mahoney, Jr, MD
Peter Newburger, MD
Deputy Editor
Alan G Rosmarin, MD


Neutrophilia refers to an increase of peripheral blood neutrophils at least two standard deviations above the mean. For adults, this generally corresponds to >7700 neutrophils/microL (typically seen in patients with >11,000 white blood cells/microL).

This topic will present the clinical evaluation of neutrophilia and its causes. Evaluation of patients with lymphocytosis and eosinophilia are discussed separately. (See "Approach to the adult with lymphocytosis or lymphocytopenia" and "Approach to the patient with unexplained eosinophilia".)


The normal range (ie, two standard deviations above and below the mean) for the white blood cell (WBC) count in adults is 4400 to 11,000 cells/microL in most clinical laboratories. Approximately 60 to 70 percent of leukocytes in the peripheral blood are mature polymorphonuclear neutrophils (PMN) [1]. Thus, the threshold for neutrophilia in most clinical laboratories is approximately 7700/microL (11,000 WBC/microL x 70 percent).

Normal values for WBC in children vary based on age (table 1).

Useful definitions include:

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Literature review current through: Dec 2017. | This topic last updated: Oct 12, 2017.
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