PRIMARY AND SECONDARY LEUCOCYTE CHANGES FOLLOWING THE INTRAMUSCULAR INJECTION OF EPINEPHRINE HYDROCHLORIDE 1

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Abstract
A biphasic alteration in the number of circulating leucocytes was observed following the intramusc. injn. of 1 mg. of epinphrine hydrochloride in 20 normal human subjects. The maximal changes in Phase 1 appeared 17 min. after injn., and were characterized by a prompt increase in the number of circulating neutrophils (45%), lymphocytes (130%) and eosinophils (47%). An over all increase (75%) in the total white blood cell count at the height of the epinephrine effect was also observed. This observation is of significance in that the clinical application of the "epinephrine test" for "hypersplenic syndromes" must be interpreted in light of the leucocyte response to epinephrine which occurs in normal human subjects. Phase 2 was characterized by an increase in neutrophils, and a decrease in lymphocytes and eosinophils, the maximal effect being apparent within 2-4 hrs. following the injn. Frequent sampling of blood is strongly recommended if clinical application of either phase of the epinephrine test be made. Evidence is presented to support the view that the delayed neutrophil response which follows the injn. of epinephrine is mediated through channels which differ from those through which the delayed lymphocytopenic and eosinopenic response to epinephrine is effected.