1. Download free Tapatalk for iPhone or Tapatalk for Android for your phone and follow the SDN forums with push notifications.
    Dismiss Notice

to have a leukocytosis or not to have...that is the question

Discussion in 'Medical Students - MD' started by necrotic brain, May 10, 2007.

  1. necrotic brain

    2+ Year Member

    Joined:
    Feb 28, 2007
    Messages:
    32
    Likes Received:
    0
    Status:
    Medical Student
    steroids can cause a leukocytosis ... yes?

    how can this be if they are immunosuppressive?!

    i would appreciate an answer.. I've been getting replies of minimal satisfaction from people i ask..

    thanks :D
     
  2. Note: SDN Members do not see this ad.

  3. UCLAstudent

    UCLAstudent I'm a luck dragon!
    10+ Year Member

    Joined:
    Sep 6, 2002
    Messages:
    5,046
    Likes Received:
    7
    Status:
    Resident [Any Field]
    Steroids cause leukocyte demargination --- they decrease the "stickiness" between WBC and the blood vessel wall. This causes more WBC to be floating freely in the blood and can elevate the WBC count.
     
  4. SoCuteMD

    10+ Year Member

    Joined:
    Nov 28, 2005
    Messages:
    8,680
    Likes Received:
    718
    Status:
    Attending Physician
    They prevent extravasation of leukocytes and reduce endothelial adhesion - increasing circulating leukocytes but decreasing chemotaxis.
     
  5. Critical Mass

    Joined:
    Feb 23, 2007
    Messages:
    1,713
    Likes Received:
    2
    Status:
    Medical Student
    I hate it when my white blood cells get sticky like that. Big mess. :thumbdown:
     
  6. Tired

    Tired Fading away
    7+ Year Member

    Joined:
    Dec 12, 2006
    Messages:
    3,886
    Likes Received:
    776
    Leukocytosis does not equal improved immune function.
     
  7. sanche60

    sanche60 Senior Member
    5+ Year Member

    Joined:
    Jul 21, 2005
    Messages:
    214
    Likes Received:
    0
    Status:
    Resident [Any Field]
    i think steroids that cause leukocytosis may cause an increase in nuetrophils being released, but they might be immature. Maybe similar to how anemia causes an increase in reticulocytes in the blood. so you have more but with decreased ability to function. I was also taught that some steroids induce leukocyte apoptosis and degeneration of the lymph nodes(like cortisol), so maybe the langerhans cells(or other antigen presenting cells) have trouble presenting to t-cells?
     
  8. Samoa

    Physician Pharmacist 10+ Year Member

    Joined:
    Feb 14, 2002
    Messages:
    8,339
    Likes Received:
    974
    It's only an apparent leukocytosis. There aren't any more leukocytes in the bloodstream, but more of them are finding their way into the vacutainer because of the demargination.

    Decreased immune function is a corollary of the demargination, as well. Leukocytes must marginate before they can enter the tissues and perform their immune functions.

    It's like a bunch of teenagers hanging out at the beach in the middle of a weekday. The reason you see them there is because they're not in class doing their work.

    I could make it sound more complicated, by including all the receptors and details of their function within tissues. Or by trying to explain how it is that steroids cause demargination. But there's no paradox here between the increased white cell measurement on a CBC and decreased immune function.
     
  9. blz

    blz Senior Member
    10+ Year Member

    Joined:
    Jan 7, 2002
    Messages:
    1,282
    Likes Received:
    4
    Status:
    Resident [Any Field]
    does anyone else want to answer the question again? lol...


    goljan is all over this
     

Share This Page