Granulocytosis: Definition, Causes & Treatment - Cleveland Clinic

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Granulocytosis occurs when there are too many granulocytes (a type of white blood cell) in your blood. It’s caused by many different conditions, including infections, autoimmune diseases and blood cell cancers. As a result, people with granulocytosis can develop varying symptoms and warning signs. Treatment targets the underlying condition.

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Overview

What is granulocytosis?

Granulocytosis involves having too many granulocytes in your blood. Granulocytes are a category of white blood cells that circulate in your blood (neutrophils, eosinophils, basophils) or that remain in tissue (mast cells). They work together to fight off infections, allergens and causes of inflammation in your body.

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Although granulocytes are a normal part of your immune system, too many granulocytes in your blood usually mean you have a health problem, like an infection. Other conditions closely associated with granulocytosis include autoimmune diseases (like rheumatoid arthritis) and bone marrow conditions like chronic myeloid leukemia (CML).

It can feel unsettling to learn you have abnormally high levels of your body’s most abundant type of white blood cell, but try not to worry. Granulocytosis has many causes, and not all of them are serious. Your provider can advise you based on what’s causing your elevated levels.

Granulocytosis vs. leukocytosis

Sometimes, people use the terms “leukocytosis” and “granulocytosis” interchangeably. But there are minor differences. Granulocytosis refers to an increase in the number of granulocytes in your blood (neutrophils, eosinophils and basophils). Leukocytosis refers to an increase in the total white blood cell count, which can be from increases in one or all of your granulocytes, monocytes and lymphocytes.

Granulocytosis vs. agranulocytosis

Granulocytosis involves having too many granulocytes in your blood. In contrast, agranulocytosis is a condition in which your bone marrow doesn’t make enough neutrophils, a specific type of granulocyte.

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Symptoms and Causes

What are the symptoms of granulocytosis?

Granulocytosis symptoms vary significantly depending on what’s causing high granulocytes. For example, when granulocytosis is the result of a bacterial infection, common symptoms include:

• Headache.
• Fever.
• Fatigue.
• Nausea and vomiting.

If you have elevated granulocytes as the result of rheumatoid arthritis, you may have:

• Joint pain.
• Stiff and swollen joints.

Symptoms associated with CML-related granulocytosis include:

• Fatigue.
• Night sweats.
• Feeling full despite not having eaten much.
• Swelling or discomfort in the upper left part of your belly.

What causes granulocytosis?

Granulocytosis can happen alongside a short-term issue, like an infection or medication side effect. Sometimes, it’s a sign of a long-term (chronic) condition. Common causes of granulocytosis include:

• Infections, including those caused by bacteria, viruses and parasites.
• Autoimmune diseases.
• Myeloproliferative neoplasms (rare blood cancers), such as chronic myeloid leukemia (CML), polycythemia vera and essential thrombocythemia.

Other causes include:

• Sepsis.
• Heart attack.
• Kidney failure.
• Metastatic cancer.
• Inflammatory bowel disease.
• Burns.
• Smoking.
• Severe emotional or physical stress.
• Certain medications, like corticosteroids.

Diagnosis and Tests

How is granulocytosis diagnosed?

A healthcare provider will review your medical history and perform a physical examination. If they suspect granulocytosis, they’ll order a complete blood count (CBC). This test requires a small sample of your blood.

Normal range vs. granulocytosis range

The normal range for granulocytes is between 1,500 and 8,500 cells per microliter of blood. Anything above these levels indicates granulocytosis.

The normal range for each type of granulocyte in your blood is:

• Neutrophils: 1,800-7,800 cells per microliter of blood.
• Eosinophils: 0-450 cells per microliter of blood.
• Basophils: 0-200 cells per microliter of blood.

Lab test results can be confusing and difficult to interpret. Talk with your healthcare provider if you’re unsure about what your results mean.

Management and Treatment

How is granulocytosis treated?

Treatment depends on what’s causing granulocytosis:

• Infections: You may need antibiotics for bacterial infections.
• Autoimmune conditions: You may need immunosuppressants to calm your immune system.
• Cancer: You may need cancer treatments, such as chemotherapy, radiation therapy, targeted therapy or a bone marrow transplant.

No matter the condition causing your high granulocytes, your healthcare provider can determine the most appropriate course of treatment. Treating the condition should also reduce the number of granulocytes in your blood.

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Outlook / Prognosis

What can I expect if I have granulocytosis?

If a complete blood count (CBC) indicates that you have granulocytosis, then your healthcare provider will begin looking for conditions that may have caused it. From there, you can discuss treatment (if you need it). Depending on the cause, you may need long-term treatments to manage the condition and return your granulocyte levels back to normal. In some cases, the condition resolves on its own and your granulocyte levels fall without treatment.

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Your provider can explain what to expect based on your diagnosis.

How long does granulocytosis last?

Typically, granulocytosis goes away once you get treatment for the underlying health condition or you stop the medication that’s causing it (if your high levels are a medication side effect). This could take a few days to several weeks, depending on your situation.

Prevention

Can I prevent this condition?

Because granulocytosis is associated with many unavoidable diseases and conditions, there’s no known way to prevent it altogether. If you develop granulocytosis, your healthcare provider will determine the cause and recommend the best treatment.

Living With

When should I see my healthcare provider?

You should visit a healthcare provider any time something doesn’t feel quite right. Many granulocytosis symptoms overlap with other conditions, so it’s important to schedule an examination so a healthcare provider can figure out what’s causing your issues.

If you’re already getting treatment for a granulocytosis-related condition, call your healthcare provider any time you notice worsening symptoms. They’ll help you find ways to manage your symptoms.

What questions should I ask my healthcare provider?

Understanding your test results can help you make informed decisions about your health. If you have granulocytosis, here are some questions you may want to ask your healthcare provider:

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• How high is my granulocyte count?
• What conditions are you testing for?
• What kinds of tests are necessary?

A note from Cleveland Clinic

Granulocytes are an essential part of your immune system. These cells help defend your body against a variety of infections. But having too many granulocytes in your blood could indicate a health issue. If you have granulocytosis, your healthcare provider will start looking for the cause. Once that’s determined, they’ll design a personalized treatment plan. If cancer is part of your diagnosis, talk to your healthcare provider about the many resources and support groups available to you.

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Medically Reviewed.Last updated on 08/06/2024.

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References

Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

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Medically Reviewed.Last updated on 08/06/2024.

References

Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

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• Kamat A and Kamat DM. Granulocytosis. In: Kamat D and Frei-Jones M, eds. Benign Hematologic Disorders in Children. 1st ed. Springer; 2021.
• Mank V, Azhar W, Brown K. Leukocytosis (https://www.ncbi.nlm.nih.gov/books/NBK560882/). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Accessed 8/6/2024.
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