Neutrophils are segmented in children. Why a child has low segmented and stab neutrophils: causes of deviations in a blood test

In childhood, very often the immune system does not cope with its task, so the child gets sick and easily becomes infected with infectious diseases. In acute inflammatory processes, according to the results of the KLA, neutrophils may be lowered or increased.

Why do leukocyte blood tests? Why do doctors look at neutrophil counts in children? Let's try to figure it out.

Segmented neutrophils: what do they do in the body?

The immunity of each person depends on the normal functionality of all bodies of the defense system. The main "warriors" in the body are leukocytes. But they are divided into several types. They also include segmented neutrophils, which are the largest number in the blood volume compared to other immunocompetent bodies.

Neutrophil cells are granular granulocytes. This means that they are able to carry out phagocytosis - the absorption and digestion of foreign agents. After performing a protective function, they die along with the captured microorganism, allergen or chemical.

Thus, any inflammatory process caused by bacteria or fungi, during which an increased activity of leukocytes is required, changes their number in the bloodstream up or down. And according to this level, a child can understand the state of the immune system - either it is suppressed, or it works at full strength.

The norm of indicators in children: when you should not worry about health?

By the percentage of neutrophilic elements, pediatricians assess the functionality of immunity. It is important to note that two types of them are found in the bloodstream:

• Stab - immature shaped elements that are not able to carry out phagocytosis;
• Segmented - mature bodies that perform the main functions of the immune system.

Leukocytes are produced in the bone marrow. This process is constant and continuous. But the rate depends on the age of the baby.

As can be seen, in children, the percentage of mature granulocytes changes throughout life and stabilizes after adolescence. Slightly lower rates compared to adult figures are the norm.

According to hematological analysis, the level of stab forms is also determined. But they should be a small amount - from 1 to 5%.

Decreased leukocyte counts: causes

When an infectious disease develops in the body, the segmented forms are sent to the focus of inflammation in order to destroy pathogens. To help them, the bone marrow actively produces new bodies, since the process of phagocytosis leads to a decrease in the number of leukocytes in the bloodstream and tissues. Thus, many stab immature forms appear in the circulatory system. But the percentage level of segment-nuclear defenders is decreasing.

The reasons for the drop in the percentage, which is called neutropenia, can be different:

• fungal infection;
• Viral defeat;
• Chemical poisoning;
• Irradiation;
• Anemic conditions of various etiologies;
• Acute leukemia;
• thyrotoxicosis.

In addition, underestimated numbers are caused by taking hormonal medications. Most often, these are glucocorticoids, anticonvulsants and painkillers. There is also a congenital decrease in the level of leukocytes, but it is quite rare. With the genetic origin of abnormalities, the baby develops immunodeficiency over time.

A drop in the percentage of neutrophilic bodies indicates a chronic process of inflammation in which the immune system cannot cope with its task. It gradually weakens its activity, and the level of formed elements decreases.

In some cases, neutropenia in children 1 year of age and older is associated with insufficient production of blood cells in the bone marrow. For example, such a phenomenon occurs when the red substance is damaged by a tumor process or metastasis of malignant neoplasms in other organs. Or the functionality of hematopoiesis is negatively affected by irradiation (radiation, chemotherapy, radiation therapy).

Symptoms of disorders in the body: what to look for?

In childhood, when the child is 3 months old or more, it is very important to control the health and functionality of the immune system. After all, its ability to fight penetrating infections depends on it.

It is necessary to take tests according to a planned medical examination. But, you should also contact your pediatrician if parents notice the following symptoms in children:

• An increase in temperature, periodically jumps of hyperthermia without acute signs of illness;
• The appearance of pustules on the skin;
• Frequent infection with viral or bacterial infections (flu, tonsillitis, otitis media);
• Increased sweating, especially at night;
• The development of stomatitis, inflammation of the gums;
• Rapid decline in strength, lack of energy to perform daily work, study.

Any of these symptoms may be factors caused by a decrease in the leukocyte group of cells. But basically, a drop in protective forces is diagnosed with an increase in temperature and frequent colds.

It is worth noting that there is benign neutropenia, which is observed in children after birth. But at 2 years old, it can pass without a trace without any treatment. At the same time, deviations do not provoke any symptoms and do not affect the development of the baby.

Forms of neutropenia: how do they proceed?

The fall in neutrophils in most cases is not associated with genetic factors that are very difficult to treat and are an independent disease. As a rule, they are caused by some kind of infectious invasions, disorders of the liver / kidneys, thyroid gland and bone marrow. That is why it is very important for diagnosis to establish the exact cause of the development of abnormalities in the blood.

Neutropenia occurs in three forms:

• Light. May cause no symptoms or be accompanied by frequent colds, local bacterial damage (for example, skin pustules that are difficult to eliminate).
• Medium . Recurrent purulent inflammations, infectious infections are noted. The patient has a lesion of the mucous membranes of the mouth (gingivitis, stomatitis).
• heavy . Accompanied by severe intoxication with symptoms coming out of it. Mucous tissues can become inflamed, suppurate, die off in small areas. In children, the temperature rises, fever develops, purulent infections often occur.

It makes no sense to remove the symptoms of disorders, because the lack of leukocytes cannot be treated as an independent disease. It is imperative to direct all actions to eliminate the root cause of the decrease in immune forces. If it is an infection, then destroy the pathogen. And when deviations are caused by a violation of the functionality of internal organs, then one should deal with the treatment of a specific disease.

How to increase segmented neutrophils: methods of therapy

For the treatment of various diseases that provoke a drop in hematological values ​​in children, it is necessary to strengthen the immune system. Regardless of the very root cause of the violations, the defenses must be maintained at a normal level so that other ailments do not join the main pathology.

What drugs are used in the treatment of diseases?

1. Antibiotics - are used exclusively for bacterial damage, if the patient has pustules, purulent inflammation of the respiratory tract. Mostly drugs from the group of macrolides are selected, because they are the least toxic for the developing organism.
2. Vitamin complexes - are required to increase immunity, enhance metabolic processes and regenerate damaged tissues. What kind of vitamins the patient needs, the pediatrician will say. You should not buy everything that is in the pharmacy, because an excess of nutrients can also have a negative effect.
3. Detoxification means - with severe intoxication, it is necessary to cleanse the body of harmful toxins. For this, sorbents and other drugs are used that accelerate the metabolism at the cellular level.
4. Auxiliary drugs - are selected depending on the symptoms of the child. If the mucous membranes of the oral cavity become inflamed, then rinse solutions are used. For nasal congestion, intranasal agents are used, etc.

If children have a severe illness, they may resort to blood transfusion. But this is a cardinal decision and the need for it arises very rarely.

White blood cells - leukocytes - perform a protective function in the human body. There are several types of such cells.

Varieties of leukocytes

- This is the largest group of leukocytes.

Classification

The cells are produced in the bone marrow.

Depending on the maturity, neutrophils are divided into 6 groups:

Mechanism of education

After the initial myeloblast cell has developed, the neutrophil gradually matures to a stab.

Then it penetrates into the blood plasma. After a period of time, the core of the element changes.

It is divided into segmented parts. This is how mature neutrophils appear.

Full-fledged cells, ready for protection, penetrate the capillary walls in 2-5 hours.

Functions of segmented neutrophils

Each leukocyte cell has its own role in the immune response:

1. Some are scouts.
2. The latter are responsible for the memory of the attack of a foreign object.
3. Still others "teach" immature cells to protect themselves.

Segmentonuclear formations are responsible for the tactics of attacking the stimulus and fighting it. Mature neutrophils destroy pathological organisms in the blood and organ tissues.

Due to the special ability to move with amoeboid movements, the formed elements can swim in the blood or move towards the target with the help of "legs".

A segmented neutrophil, reaching the focus, envelops foreign cells and destroys them. In this case, the neutrophil itself dies.

During death, he releases a special substance into the blood, which serves as a signal that attracts other elements to help. Such a process occurs, for example, in a decayed wound. Millions of dead cells are found there.

In the total number of neutrophils in the blood, 45-72% are cells with segments in the nucleus. This is an indicator of the norm.

It varies depending on several factors:

1. The age of the person. In newborns, the indicator may be at the maximum level. During the first month of life, there is a decrease down to the minimum percentage of immature cells. When a child reaches 6-7 years of age, the number of segmented neutrophils stabilizes. The immune system is getting stronger. After 7 years, a child's norm of mature elements coincides with those of an adult.
2. Absolute score. In some cases, such a value is taken into account, which is calculated by the number of mature cells per microliter of blood. The norm in an adult is 1800-6500 neutrophils.
3. Temporary factors. Mostly, deviations occur in children. The decrease and increase occurs after vaccination, during teething.

In other cases, deviations from the norm are a sign of an inflammatory process.

Decreased segmented neutrophils

The deviation from the norm in the blood is explained by:

• Diseases of the circulatory system;
• Severe allergic reactions;
• The use of chemotherapy in the treatment of cancer;
• Taking antiviral drugs;
• Protracted viral infection;
• Thyroid disease (thyrotoxicosis)
• Bad ecology;
• Anemia;
• Exposure to radiation;
• Chemical poisoning;
• Hereditary predisposition associated with gene mutation.

Segmented neutrophils are reduced due to prolonged use of certain drugs.

For example:

• Analgin;
• Penicillin;
• Ribavirin.

A decrease in the rate is diagnosed in 95% of patients who are treated with these drugs.

Neutropenia may be temporary. A slight deviation from the norm is observed within 3-4 days after infection with influenza, adenovirus infection.

Severe neutropenia indicates a serious inflammatory process:

• Pneumonia;
• Ulcerative stomatitis;
• Complications after an infection.

For some people, a reduced rate of segmented neutrophils in the blood is an individual feature. According to various sources, their number ranges from 20% to 30%.

Blood test

There are no health problems observed. This feature is reflected in the outpatient card.

Increased rates

What is an increase in the rate of neutrophils in a blood test? This means that the bone marrow produced too many immature neutrophils during the illness.

After recovery, immature blood elements were transformed into full-fledged cells, ready to protect the body. The increased value of neutrophils was reflected in the analysis.

A condition in which the level of segmented neutrophils increases is called neutrophilia (neutrophilia). The indicator exceeds 75% of the total number of neutrophils.

An increase in the number of segmented cells in the blood is sometimes associated with stress, physical overstrain, and increased mental stress.

• Prevention of viral infections;
• Compliance with hygiene rules;
• Balanced diet.

Video - Neutrophils blood test

Every parent is responsible for the health of their child. And a general blood test is an important assistant in this difficult matter.

After passing the blood test, the results are interpreted and studied by the doctor. The presence of normal indicators indicates the health of the child's body.

If the doctor finds any deviations from the usual values, parents will be asked to conduct additional examinations of the child.

What are neutrophils?

Neutrophils in the blood are one of the varieties of white blood cells - leukocytes and granulocytes. Being in the blood, they occupy about 75% of the total number of white blood cells.

Neutrophilic granulocytes are a very significant component of leukocytes. Their number will necessarily be recorded in the leukocyte blood formula, and is designated as neut .

An indicator of the number of neutrophils that does not go beyond the established range indicates the correct functioning of the child's immune system. It effectively protects the child's body from bacteria and viruses that enter it.

What role do neutrophils play?

The production of neutrophilic granulocytes is carried out in the red bone marrow. This organ plays a major role in the processes of hemo- and immunopoiesis.

The life span of neutrophils is short (about a few hours), so they are regularly updated.

A characteristic feature of newly formed cells is the granularity of their internal structure.

The granules contain antibacterial substances, through which blood cells provide the following functions:

• Protection of the body from the penetration of bacteria, viruses and infections.
• Capture and absorption of foreign particles - phagocytosis.

With the correct performance of the specified functions, the human body has good immunity. If there is a change in the concentration of neutrophils, we can talk about the presence of any disease.

Normal performance

Cells circulating in the blood can be classified as follows:

• Mature neutrophils are segmented.
• Immature neutrophils are stab.

The nucleus of mature cells is divided into segments (hence the name), while in immature cells it visually looks like solid curved rods.

In the blood of a healthy person, there are much fewer young cells than segmented ones.

In a child who does not suffer from any diseases, the level of mature cells varies between 16-70%. The exact indicator does not change depending on gender, but is directly related to the age of the child.

Table "Neutrophils in children are normal in a blood test"

The maximum number of immature neutrophils is found only in newborn babies. Over time, these indicators decrease, and the main place is given to segmented cells.

This happens because only mature neutrophils are able to withstand harmful particles penetrating from outside. A stable level of immunity is directly related to the optimal level of granulocytes for age.

Deviations from the usual values

There are cases when the norm of neutrophils in children is exceeded or vice versa, reduced. Both conditions have specific symptoms, causes, and consequences.

Increasing values

The number of granulocytes in the blood of a child that exceeds the permissible parameters is fraught with serious consequences.

The absence of any symptoms and a small jump in neutrophils indicate factors such as:

Stressful situations, overexertion.

Blood loss.

Usually in such situations, excitement is not justified.

You can judge the presence of the disease with a large jump in the level of neutrophils in a child after a year. The number of granulocytes, exceeding the usual, indicates the development of neutrophilia in the baby.

The causes of this disease are as follows:

• Malignant diseases of the blood.
• Trophic ulcers.
• Vaccinations.
• Otitis, pneumonia, tonsillitis, sepsis, occurring in an acute form.
• Diabetes.
• Purulent inflammation of tissues.

Inflammatory processes are directly related to the level of neutrophils in the blood: the higher it is, the stronger the inflammation. To alleviate the condition, it is necessary to immediately identify the cause of the disease and prescribe appropriate therapy.

Decreased neutrophil values ​​in peripheral blood

A decrease in the level of neutrophils indicates a deterioration in the state of the immune system of the child's body. This occurs due to insufficient production of blood cells, their rapid destruction or their incorrect distribution. The resulting clinical and laboratory syndrome is called neutropenia.

The reasons for the development of this pathology are as follows:

1. Disorders in the work of the bone marrow.
2. Leukemia in an acute form.
3. Sharp weight loss.
4. Fungal disease.
5. SARS, hepatitis and other diseases of a viral nature.
6. Intoxication.
7. Irradiation.
8. Anaphylactic shock in history.
9. Side effects of taking certain drugs.

There is no cause for concern if, despite the low level of neutrophils, a baby under the age of one year feels good. The level of blood cells normalizes when the child reaches the age of three.

Treatment

Only a specialist can choose the necessary therapy for changing the level of neutrophils. Independent uncontrolled use of various drugs will provoke a sharp decrease or increase in the indicator to critical levels.

Decrease in indicators

With increased values ​​of granulocytes, the following medications can be prescribed to a small patient, depending on the indications:

• Immunosuppressants and cytostatics,
• Anti-inflammatory.
• Antiviral.
• Antibacterial.

• Diets.
• Physiotherapy measures according to indications,

The implementation of complex therapy should be carried out under the control of blood tests.

Increased values ​​- what to do with neutropenia?

Therapy with a low level of neutrophils is aimed primarily at improving immunity.

This will help:

• Taking multivitamins,
• Improved balanced diet.
• The absence of stress, chronic infections is a preventive direction.

Sometimes a decrease in values ​​is accompanied by the development of stomatitis, periodontal disease, etc. In this case, the child is shown rinsing his mouth with antibacterial drugs. Decoctions and infusions of medicinal herbs (St. John's wort, chamomile, etc.) will bring benefits.

In human blood, in addition to hemoglobin-stained erythrocytes (red blood cells), several types of "white" cells - leukocytes - circulate. "White blood" is responsible for the protective reactions of the body and the formation of inflammation. The quantitative ratio of different types of leukocytes in the blood is called the leukocyte formula and is the subject of planned and urgent diagnostics.

Among the leukocytes in the blood, the most numerous are neutrophilic granulocytes (neutrophils, NEUT)- small cells with granular contents (granules) that react to laboratory staining with both acidic and basic (alkaline) dyes. From the ability to perceive both types of pigment, these cells got their name.

A person is constantly in contact with a huge number of microorganisms invisible to the eye (bacteria, viruses, fungi, protozoa), densely populating not only the entire surrounding space - air, surfaces of objects, food - but also the body itself.

For example, this:

• outer covers;
• oral cavity;
• upper respiratory tract;
• gastrointestinal tract;
• terminal ducts of the genitals.

Entering the body or being constantly present in it, the microflora tries to use its space and resources for life, nutrition and reproduction, which can lead to intoxication, weakening and death of the host organism. To prevent this from happening, a complex defense system is constantly functioning in the blood and tissues of higher beings - immunity - represented by leukocytes and antibodies.

It is neutrophils that are responsible for the ongoing, ongoing control of all systems and organs and the destruction of foreign agents, as well as the primary actions to eliminate the infiltrated infection and induce inflammation. Thanks to the operation of this “first response system” of non-specific immunity, a person can exist without showing any signs of invading microorganisms and without even noticing this struggle.

With a decrease in the pool of neutrophils in the blood, the following changes are observed:

In severe forms of neutrophilic immunodeficiency, a person can only live in an isolated sterile chamber.

Functions of neutrophils:

Depending on the degree of maturity (and the ability to perform protective functions), several types (stages of development) of neutrophils are distinguished.

Bone marrow immature neutrophils:

1. Myeloblasts- embryonic (stem) cells of future granulocytes, originating in the bone marrow from stem cells common to the entire circulatory system. Normally, these cells should be present only in the bone marrow, the main human hematopoietic organ. The appearance of blasts in the blood indicates leukemia - a malignant process in the blood (up to 2% in a chronic form and up to 5% in a crisis).
2. promyelocytes- the stage of maturation of the myeloblast nucleus, the cytoplasm of which is still in its infancy, but already contains granules with the main bactericidal enzymes.
3. Neutrophil myelocytes- precursors of neutrophils, differentiated from two other forms of granulocytes (eosinophils and basophils). The period of division and formation of precursors to the metamyelocyte stage lasts approximately 4 days.
4. Neutrophil metamyelocytes (young) - finally differentiated and maturing neutrophils. Ripening time is usually around 5 days.

Promyelocytes, myelocytes and metamyelocytes are distinguished by a large unformed nucleus and immature cytoplasm, which contains few granules with working enzymes and complexes and is not able to perform protective functions. These young cells can enter the blood in an amount of not more than 1% of the total proportion of leukocytes in the leukocyte formula.

In the case of an increase in the indicator to 3-5%, one of the following possible states is indicated:

Adult peripheral blood neutrophils:

1. stab neutrophils(in medical jargon - "sticks") - formed maturing bodies with a nucleus in the form of a curved cylinder (rods), leaving the bone marrow pool into the blood. These cells already have the main supply of active reagents in the cytoplasm, but they still cannot actively resist infection, carry out phagocytosis and infiltration into tissues. At the beginning of the infection, the number of "rods" in the blood increases sharply, and when the pool of bone marrow stem cells is depleted, it decreases.
2. segmented neutrophils("segments") - full-fledged, fully formed and mature neutrophilic granulocytes with a nucleus constricted into segments capable of performing all their functions. After several hours of free circulation in the bloodstream, a mature neutrophil attaches to the inner wall of the vessel, forming a parietal pool - a group of relatively immobile cells that, if necessary, can quickly detach from the endothelium and migrate to the inflammation site or wound.

Internal movements of blood neutrophils from the parietal pool into the bloodstream and back are called "redistributions" and cause the so-called redistributive shifts in the leukocyte formula, which are a variant of the physiological norm, but may be the cause of incorrect interpretation of blood tests.

Redistribution of neutrophils occurs not only when an infection or inflammation is detected, but also with a sharp drop in environmental temperature (especially after moving from a cold to a warm room), within 2 hours after a meal, after physical or emotional stress.

With age, there is a tendency to increase the parietal pool.

After spending about 6 days in the blood, a mature neutrophil infiltrates into the tissue intercellular space, where it lives for about 2 days in the absence of a pathogen, and then programmedly dies and is absorbed by another type of blood leukocytes - monocytes.

If a neutrophil detects and neutralizes any foreign particle, its life time is reduced. The segmented neutrophil is the main working unit of nonspecific immunity, therefore this cell type forms the basis of the leukocyte formula of a person of any age.

Neutrophils in leukocyte formula

Neutrophils (the norm in children by age decreases during the first year of life and rises to adulthood) are most indicative in the form of a leukocyte formula (leukogram). A leukogram is the ratio of different types of "white" blood cells in the body, which is compiled by counting each type of cell in the visible field of a blood smear under a microscope.

Types of neutrophils in the leukogram are arranged according to the degree of maturity from left to right. With an increase in the number of stab bodies or the appearance of precursors (metamyelocytes, myelocytes, promyelocytes, and even more so blasts), they speak of a "shift to the left", with reduced values ​​of "rods" or the detection of a large number of segmented neutrophils with more than 5 segments - a "shift to the right".

Each of these violations indicates a deviation of the state of health from the norm or significant pathologies.

Leukocyte counts are expressed in the following units:

1. Absolute(number of cells/particles).
2. Relative. Expressed as a percentage.

Absolute have identical values ​​in SI units:

• (number) / l (an example of the norm in adults is 4400000000);
• (number) * 10 9 / l - cells per liter of blood (4.4);
• cells/l - cells per liter of blood (4400000000);
• G / l - grams per liter of blood (4.4);
• Gchast / l - grams or particles per liter of blood (4.4).

Also measured in traditional measuring units:

• (number) *10 3 /µl (1000/µl) - cells per microliter (µl) of blood (4.4);
• (number) * 10 3 / mm 3 (1000 / mm 3) - cells in a cubic millimeter of blood (4.4);
• c/mkl - cells per microliter (4.4);
• c / mm 3 - cells in a cubic millimeter (4.4);
• cells/µl – cells per microliter (4400);
• cells / mm 3 - cells in a cubic millimeter (4400).

The norm of neutrophils in the blood in children by age: table

In the blood of an adult (over 13 years old), the presence of all types of leukocytes in the amount of 4 - 10 * 10 9 / l of blood is considered normal, of which neutrophils - from 48 to 80% (1.8 - 6.5 * 10 9 / l) .

For example:

1. Young neutrophils (predecessors) should occur in an amount of no more than 1-3%.
2. Stab - from 1 to 6%.
3. The remaining share (45-72%) is occupied by segmented neutrophils. The predominance of segmented neutrophils over other "white" blood cells indicates a "regular" state of immunity - the body's readiness for a potential infection invasion, the absence of data on current or recent (within 2 weeks) infections and inflammatory conditions.

Neutrophils (the norm in children by age is presented in the table) show other ratios during the period of human growth. In children under 12 years old, the formation of the immune system and the constant “training” of immune responses in infectious diseases take place; at the same time, another picture of a normal leukogram is observed.

Infants are born with a high, "adult" value of segmented neutrophils in the blood, which increases until the end of the first day of life, and then drops sharply.

This phenomenon coincides with the opposite dynamics of lymphocytes (low value-decrease-increase), the phenomenon was called the "first overlap" (the intersection of the curves on the graph occurs on the 3rd-5th day of life). At the age of 5-15 days, the index of segmented cells remains low (slowly decreasing), and subsequently begins quickly (up to a month), and then gradually increases.

At about 5-7 years, this physiologically natural low situation in the neutrophil link approaches the norm for adults (“second overlap”, reflecting a simultaneous decrease in the number of lymphocytes, as well as stab cells).

The norm of neutrophils in children by age is indicated in the table of the general blood test.

At this time, pediatricians and parents note a decrease in the frequency of colds and food poisoning - the most striking clinical manifestations of the state of the immune system. In the future, the rate of mature neutrophils continues to increase and reaches adult values ​​by 12-14 years.

Age norms of neutrophils in the leukogram of children:

Age	Stab neutrophils, %	Segmented neutrophils, %
First day	1-5	50-70
1-5 days	1-5	35-55
5-15 days	1-4	25-45
15 days - 1 month	1-5	15-30
1 – 12 months	1-5	20-35
16 years	1-4	35-55
7-10 years old	1-4	40-60
11-15	1-4	40-75

How to determine the level of neutrophils: tests and studies

All granular granulocytes are examined in three ways:

• using a clinical blood test;
• in a biochemical blood test;
• bone marrow biopsy.

General blood analysis

In most planned and clinical situations, a general blood test, which is taken from a finger, is sufficient for diagnosis. Since the "white" cells are able to quickly respond to normal physiological fluctuations in the state of the body by redistributive shifts, and the bone marrow - by changing the rate of hematopoiesis, then you need to follow some rules for preparing for blood donation.

They are the following:

1. Hunger. Before blood sampling, it is necessary to refrain from eating and drinking for 6 hours (for infants - 2 hours). Food enhances the work of stem cells and the release of the bone marrow pool, and also stimulates the activation of "sleeping" parietal neutrophils to the possible invasion of pathogens and toxins from food.
2. Diet. A few days before the delivery of the KLA should be excluded from the diet: fatty; acute; canned food; if possible - products with nutritional supplements. All these types of food cause a load on the immune system. Drugs (especially alcohol-containing ones) can also lead to strong changes in the standard individual leukogram.
   
   
3. physical rest. Intense muscle loads (physical labor, sports, outdoor games) enhance: the synthesis of new neutrophils in the bone marrow; cause the release of young forms of cells into the blood; lead to thickening of the blood; cause an increase in blood flow, washing out the parietal pool into the mainstream; perhaps the immune system reacts with a neutrophilic surge to the appearance of harmful decay products in the blood, which is observed with increased muscle work, especially in untrained people.
4. Emotional stability. Acute stress, emotions of fear, joy and sadness, sudden events and news are accompanied by a surge of adrenaline and cortisol, which, as with muscle exercise, stimulate neutrophilopoiesis and contribute to the distortion of the study results.
5. Even temperature conditions. Temporary fluctuations in leukocyte balance cause sudden changes in ambient temperature, for example: moving from a heated room to a cold place or from an air-conditioned room to a hot street; taking a hot bath or shower; dressing in a cool room; wrapping babies. All this can also be reflected in the leukogram. To equalize the values, it is necessary to spend about 15 minutes in homogeneous mode.
6. No damage to the skin. "Rejuvenate" the leukocyte formula and can mask hidden infectious and inflammatory processes in the body: burns; cuts; wounds; scratches; bruises; surgical interventions; dental procedures; eczema and dermatitis.
7. Pausing after vaccinations and blood transfusions. Depending on the type of vaccine, the waiting period can be from 1 to 4 weeks.
8. Premenstrual period and mid-cycle in girls, they can cause not only shifts in the values ​​of mature neutrophils, but also the appearance of young forms. For the reliability of the results of the KLA, it is better not to donate blood a week before the onset of menstruation and 4-5 days after their end, and also, if possible, to determine the exact cycle, 2 days during ovulation.
   
   
9. Second half of pregnancy and childbirth cause "left shift" up to myelocytes and blasts. During the bearing of a child, the hematopoietic function of the bone marrow and the production of all types of leukocytes in response to the appearance of an embryo are enhanced, and early pregnancy and childbirth are a stressful state of the body, leading to active changes in the immune system. However, the rate of immature forms, even in this case, does not exceed 3%, and the increase in the proportion of stab - 6%. An increase in the number of segmented cells is considered natural.

Blood chemistry

Neutrophils (if the norm in children by age has strong deviations) require a closer study. LHC is used to clarify and expand the data of several samples of the general blood test while maintaining persistent deviations and especially a sharp “left shift”.

Bone marrow biopsy

A biopsy is required with a stable significant shift of the leukogram, especially to the left side.

It is also needed when the norm of young forms is exceeded by more than 5%, when there are no indications in the history of:

• severe course of any infectious disease;
• intoxication;
• exposure;
• long-term use of specific medications;
• blood loss;
• prolonged coma;
• chronic stress;
• acidosis and alkalosis caused by acute or chronic disorders of the internal organs and metabolism.

An increase in the rate of young neutrophils above 10% usually indicates malignant hematological pathologies (myeloproliferative diseases), and a decrease below the norm indicates chromosomal disorders in the synthesis of blood cells, the etiology and stage of which are helped by a myelogram and cytogenetic analysis of bone marrow biopsy.

Additional factors reinforcing the need for such a procedure are:

• the presence in the blood of erythrokaryocytes - blast cells of red blood cells;
• the proportion of platelets is above 450*10 9 /l (thrombocytosis);
• high content of eosinophils (over 5%) - another type of granular white blood cells;
• an increase in the number of basophils (the third type of granulocytes) more than 1%;
• low value of alkaline phosphatase of neutrophils;
• clinical manifestations of myeloproliferative diseases (weight loss, fatigue, bleeding and thrombosis, impaired consciousness, joint pain).

A biopsy is prescribed after a weighted analysis by a specialist of all the CBC data and anamnesis and is performed on an outpatient or inpatient basis under local anesthesia (sometimes with sedation).

Material sampling localization:

• in adults, the material is taken from the sternum;
• children are more likely to undergo a biopsy of the pelvic bone;
• in infants, it is easier to manipulate the calcaneus, tibia, or femur.

The procedure is quite safe and relatively painless, lasts about 3 minutes, does not require careful preparation and restorative treatment.

Deviations from the norm

The norm of neutrophils in children may vary slightly with age. Changes in their normal values ​​in absolute (in numerical terms) or relative (as a percentage) units indicate the general state of their increase or decrease. More informative is the extended leukocyte formula with the presence or absence of shifts in the scale of cell maturity.

When neutrophils are elevated

Neutrophilic leukocytosis (neutrophilia, neutrophilia) is observed in the following conditions:

The normal course of any of these disorders is considered to be an increase in predominantly unchanged segmented nuclear forms and a slight “left shift” with an increase in the proportion of stab neutrophils, which is observed when the body successfully fights non-dangerous acute infections and inflammations.

Purulent-septic conditions are accompanied by an increase in predominantly stab bodies and the appearance of metamyelocytes.

After the depletion of the white germ (stem bookmarks of white blood cells in the bone marrow), which is observed in protracted infectious and purulent-septic diseases with a severe course, even younger stages of neutrophils (up to blast ones) are found in the leukogram and eosinophils disappear.

"Rejuvenation" of the formula (extreme left shift) may indicate malignant processes in the bone marrow. Inhibition of the hematopoietic function of the bone marrow during endogenous intoxication, severe and prolonged infections is characterized by the appearance of degenerative (altered) segmented forms against the background of an increase in the content of stab cells.

A decrease in their proportion, accompanied by a "right shift" with destruction of the nucleus of segmented neutrophils, may indicate:

Symptoms

If neutrophilia is manifested by clinical symptoms, then these are usually signs of the disease that caused this state of the leukogram.

In general, increased values ​​of neutrophilic granulocytes correspond to the following phenomena:

• general weakness;
• increased body temperature;
• dizziness; impaired vision and consciousness;
• muscle pain;
• fainting;
• dystrophy.

Medical treatment

If neutrophilia is caused by an adequate response of the immune system to an invading infectious agent, then violent methods to reduce the number of neutrophils are not necessary.

Treatment in this case is:

• elimination of the cause of neutrocytosis - the introduction of antibiotic, anthelmintic, antiviral or antimycotic agents;
• antihistamines;
• anti-inflammatory drugs.

Malignant tumors require appropriate treatment.

Usually this:

• hormone therapy;
• radiation and chemotherapy;
• bone marrow transplantation;
• transfusion.

The consequences of severe neutrocytosis (observed, for example, in tumors), such as cerebrovascular accident, childhood priapism, and others, require direct action on the volume of blood neutrophils. To reduce hyperneutrocytosis, cytostatics, anticoagulant therapy, leukocytopheresis are used.

Consequences

In most cases, the prognosis for neutrophilia is favorable: at the end of infectious inflammation, and sometimes in its final stage, the number of neutrophils decreases independently.

If neutrophilic leukocytosis is caused by severe disorders of the hematopoietic system, then an excess of granular cells is deposited on the inner wall of the vessels and can lead to blockage of small capillaries.

Neutrophils are below normal

Neutrophils (the norm in children by age should not be below the average value) can show an extremely low content. Neutropenia (neutrophilic leukopenia, agranulocytosis) is a decrease in the normal number of neutrophils in the leukogram, which is observed in various processes.

For example:

Symptoms

The main symptom that allows the doctor to suspect neutropenia is frequent respiratory infections (over 8 times per year).

With the progression of deficiency in a child, chronic processes are diagnosed:

Other symptoms are:

• enlargement of the spleen;
• swollen lymph nodes;
• general weakness.

In children with an extremely pronounced neutrophil deficiency (below 0.5 * 10 9 / l), when the body meets a representative of the pathogenic and even its own microflora or the activation of a “sleeping” virus (for example, the herpes virus or cytomegalovirus), neutropenic fever (febrile neutropenia) may develop - a dangerous condition with pronounced and rapidly developing symptoms.

They are the following:

Medical treatment

Treatment of neutropenia consists in establishing and feasible elimination of the disease factor.

Therapy usually includes:

• antibiotic therapy;
• hormonal drugs;
• cytostatic agents;
• immunoglobulin (with autoimmune and febrile neutropenia).

Consequences

Chronic neutropenia of mild to moderate severity is manifested by frequently recurrent bacterial and fungal infections.

Severe deficiency leads to life-threatening conditions in which the body is unable to cope even with low-virulence pathogens without powerful and unsafe therapy with corticosteroids, antibiotics, colony-stimulating factors, and bone marrow surgery.

Prevention of changes in the level of neutrophils

Preventive actions aimed at stabilizing the neutrophil link of the blood coincide with the general principles of strengthening immunity and are carried out during periods of remission of chronic infectious diseases.

For example:

In order to protect the child from possible serious illnesses and to identify deviations in the state of his health in time, parents should not ignore such simple and informative diagnostic methods as a clinical blood test.

Having received the child's leukogram, the attending physician will assess the content of neutrophils, compare them with age norms, draw up a clinical picture and, in case of discrepancy, will be able to take the necessary measures in advance.

Article formatting: Lozinsky Oleg

Video about the norm of neutrophils in children

What are neutrophils and what are they responsible for:

Indicators of the main parameters of a blood test are important in assessing the state of human health. Particular attention is paid to children under the age of one year. It is necessary to donate blood for analysis every month, if any shifts from the norm are found, even more often. Neutrophils are a type of leukocytes and perform a protective function in the body. There are two types of neutrophils: segmented and stab. If it is found that segmented neutrophils are lowered, we can talk about low immunity in a child.

Neutrophils fight bacteria that enter the body. They, surrounding an alien body, dissolve it in their own. At the same time, they themselves die, but instead of them, new neutrophils begin to be produced. The segmented type of protective cells is able to fight only bacteria and fungal infection, it remains powerless before viruses.

If during an infectious disease an increase in the number of segmented neutrophils is found in an infant, this indicates a high level of immunity.

The study requires capillary blood, which is taken from a finger. In newborns, the fence can be taken from the heel. You can not feed the child or give him to drink.

In determining the norm of blood test parameters, the age of the child plays an important role. In children, there are immature forms of neutrophils in the blood - stab. They are absent in adults.

If the indicators in the decoding of the analysis have a slight shift from the norm, then you should not worry about any pathological processes. The change in indicators can be influenced by the physical activity of the baby.

Reasons for exceeding the norm

If a significant deviation from the norm is found, and this indicator lasts for a long time, it is worth undergoing an additional examination. There can be many reasons:

• Hemolytic anemia.
• Leukemia.
• Appendicitis.
• Diabetes.
• Inflammatory diseases of the internal organs.
• The presence of pustules: abscesses, phlegmon.
• Severe burns.

It may also be that the total number of neutrophils is normal, but the level of the segmented type is increased. Similar parameters can occur in the latent course of infectious and inflammatory diseases or in tumors of various origins.

An increase in rates may occur as a result of a recent preventive vaccination or against the background of taking certain medications, such as corticosteroids.

To normalize the number of neutrophils, you need to identify the cause of the increase in their number. Antiviral, anti-inflammatory, antibacterial, or anticancer drugs may be prescribed. Diet and physiotherapy exercises are prescribed.

Low rate

A decrease in neutrophils indicates low immunity. This means that they quickly die in the fight against bacteria, are not produced in sufficient quantities and are not properly distributed in the body.

The main reason for the decrease in the level of neutrophils in infants is an infectious or inflammatory disease, as well as pathological processes occurring in the brain. There are other reasons for the decrease in the indicator:

• Fungal diseases.
• Severe viral or bacterial infection (measles, herpes, influenza).
• Body poisoning.
• Allergic reaction, manifested in the form of anaphylactic shock.
• Blood disease (leukemia).
• Irradiation.
• Anemia and beriberi.

Some painkillers and anticonvulsants can lead to changes in the white blood cell count.

If neutrophils are lowered and leukocytes are increased, then this occurs against the background of a viral disease, with tuberculosis, disorders in the thyroid gland, and with malignant blood diseases.

It happens that the indicators differ sharply from the norm, but at the same time the baby grows and develops normally. There are no signs of the disease. In this case, we speak of benign neutropenia. Parameters return to normal with age.

Neutropenia, depending on the severity, may occur without symptoms or manifest itself with various signs.

1. Changes in the blood can be detected by chance, after several long illnesses with SARS.
2. The average severity is characterized by frequent colds with lesions of the mucous membranes. Pustules and sores appear on the mucous surface.
3. Severe severity is manifested by symptoms of intoxication of the body, fever. Frequent inflammatory diseases of the internal organs, for example, pneumonia.

Since a decrease in the level of neutrophils indicates a weakening of the body's defenses, the basis of therapy is vitamin-mineral complexes and immunomodulators.

If during the decoding of the blood test deviations in the parameters were detected, you should not immediately panic. Further monitoring of the child and re-testing will help keep the situation under control.