Effects of stress:
- Immediate (seconds to minutes), total and differential leukocyte counts tend to increase in proportion to their normal circulating numbers from the effects of epinephrine.
- Later (minutes to hours), neutrophil counts may be increased, while lymphocyte and eosinophil counts may be decreased, mediated primarily by endogenous glucocorticoids. Indeed, It is well established that corticosteroids can reduce eosinophils, raise neutrophils and reduce lymphocytes.
- With more mild stressors, only one or two of these leukocyte changes may be observed.
- Many studies have explored the utility of stress leukogram (express as neutrophil-to-lymphocyte-count ratio [NLCR] with or without eosinopenia) for diagnostic, prognostic or monitoring purposes in patients with various inflammatory disorders, including infections.
- However, the stress leukogram is not specific for any of these conditions. It is also seen those with:
- Acute pancreatitis
- Acute myocardial infarction
- Acute trauma
- Emotional stress
- The lack of specificity limits the applicability of the stress leukogram to clinical practice.