Peripheral blood cell changes in response to acute hypoglycaemia in man

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Abstract
Peripheral white and red blood cell changes were studied in response to acute insulin-induced hypoglycemia in 6 normal, 6 splenectomized and 5 sympathectomized (tetraplegic) subjects. The normal subjects were restudied during .beta.-(propranolopl) and .beta.1-selective (metoprolol) adrenergic blockade. In the normal subjects a lymphocytosis immediately followed the acute hypoglycemic reaction (R) with a neutrophilia 2 h later. The early lymphocytosis was absent in sympathectomized subjects (P < 0.001) and reduced under .beta.-blockade (P < 0.02) in normal subjects, indicating mediation via an adrenergic mechanism. The later neutrophilia from R + 60 min was not abolished by adrenergic blockade or preceding sympathectomy; the enhanced response with propranolol was associated with an elevated plasma cortisol. Hb, packed cell volume and total erythrocyte count rose maximally at R in all groups except the sympathectomized subjects in whom all parameters declined progressively from basal values. These peripheral erythrocyte changes appear to be mediated via an adrenergicblockade and which does not involve splenic contraction.