Absolute Lymphocytosis Associated with Nonsurgical Trauma

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Abstract
Absolute lymphocytosis after nonsurgical trauma was investigated in three patient groups at an acute-care tertiary referral hospital. The first group, with mild-to-moderate trauma, consisted of 64 patients who survived knife wounds to the chest and abdomen. Thirteen of the 64 patients had admission lymphocyte counts greater than 5.0 × 109/L (mean ± SD: 6.0 × 109 ± 2.4 × 109). Within 24 hours, all 13 showed a significant drop in lymphocyte count to 1.9 × 109 ± 0.9 × 109/L. The second group, with severe trauma, consisted of 11 patients admitted to the intensive care unit. Admission lymphocyte values averaged 5.9 × 109 ± 0.6 × 109/L and decreased to 1.5 × 109 ± 0.3 × 109/ L within six hours. The relative importance of trauma as a cause of lymphocytosis was established by reviewing all hospitalized patients with lymphocyte counts greater than 5.0 × 109/L between August 1983 and October 1985. The survey indicates that trauma and hemorrhage account for 16% of all cases of lymphocytosis, and that trauma, together with other acute stresses, constitutes the most common cause of lymphocytosis studied. The authors conclude that trauma is frequently associated with a lymphocytosis that usually changes to a lymphopenia within hours of injury.