• Monocyte is the largest cell in the circulating blood(about 12-22 micrometers in size), it contains a large volume of cytoplasm, which is colored dark gray (often referred to as “the sky on a cloudy day”). The cytoplasm is distinguished by fine azurophilic granularity, which is distinguishable only with sufficient staining of the cell smear.

• The core is large enough, has friability, polymorphism, in the form of a trefoil, bean, horseshoe, occurs in the form of such an insect as a butterfly with open wings.
• The precursor of these cells (CFU-GM) is one with granulocytes, and the predecessor of the monocytic germ itself is CFU - M. These cells leave the bone marrow, not fully matured, live in the bloodstream for about 20-40 hours, then they leave the peripheral circulating blood and move to the tissues, where they completely specialize.
• Once cells leave the bloodstream, they can't come back again.. Monocytes released into the tissues become macrophages (in some organs they have specific names, namely: Kupffer cells of the liver, histiocytes contained in the connective tissue, alveolar, pleural macrophages, osteoclasts, microglia of the nervous system). In the living cells of the organs themselves, they have the ability to live from a month to many years.
• The movement of monocytes is similar to the amoeboid They also have phagocytic ability. They digest not only their own dead cells, many microorganisms and fungi, but also cells that are aging, such as blood elements, and infected with viruses.
• They destroy at the expense of their functions and the structure of the focus of local inflammation and create conditions for the process of reparation. But in the bloodstream itself, cells almost do not have their phagocytic activity.
• In addition to the process of phagocytosis, monocytes have secretory and synthetic abilities.. They are able to synthesize and produce a combination of factors such as inflammation mediators: interferon-a, interleukins-1,-6, TNF-α.

Determination of the level of monocytes in the blood

The Complete Blood Count (CBC) is currently the most popular screening test required
rnoe, to any person.

It is constantly used as a screening, one of the most important primary research methods for a wide variety of pathological conditions, so it is used to determine the level of these cells.

This analysis allows you to determine the total number of all leukocytes and the proportional ratio of various forms among them, this is called the determination of the leukocyte formula.

There is no specific preparation for the examination. It is advisable to take the test in the morning on an empty stomach or two hours after a meal.

The norm of monocytes in the blood

They represent a special category of leukocytes and are defined both relative (as a percentage of the total number of leukocytes) and in absolute numbers.

A general blood test allows you to calculate the relative number, but there are special methods that allow you to determine the absolute number of cells per unit volume (usually a liter of blood). Moreover, the number of cells has no sex dependence, sometimes even age.

The ratio of monocytes in human blood is presented in the table below:

Causes of deviation from the norm

Decrease in the number of monocytes

We can talk about a decrease in these cells (this symptom is called monocytopenia) when the number of these cells drops to 1% or less. At present, such conditions are rare.

The most common reasons for changes in these cells are:

1. the period of gestation and childbirth (if we talk about pregnancy, it is worth pointing out that in the 1st trimester, all women show a significant decrease in all blood cells, including monocytes, and at the time of childbirth, all reserve resources in the body are depleted) ;
2. weakening of the body (with various diets, chronic diseases; it is necessary to closely monitor the decrease in monocytes in childhood, because the vital activity of all internal systems and organs will be disrupted, and the child's body will subsequently not fully develop);
3. the effect of chemotherapeutic drugs and the state after radiation exposure (aplastic anemia develops, more often in women);
4. complicated purulent conditions and acute infectious processes (for example, salmonellosis).

What does elevated monocytes mean?

If they are more than normal, above 11% (such a symptom is called monocytosis), then this indicates the presence of foreign microorganisms or agents, which is specific for infectious conditions and tumors of various histological nature.

The following conditions can be sources of monocytosis:

• Infectious mononucleosis;
• acute inflammatory diseases of an infectious nature (diphtheria, influenza, rubella, measles) in the early stages of convalescence - infectious monocytosis;
• specific diseases (syphilis, tuberculosis);
• lymphomas;
• systemic disorders of connective tissue development (lupus erythematosus);
• leukemia.
• protozoonoses and rickettsiosis (leishmaniasis, malaria);
• postoperative period (especially after extensive operations on the organs of the gastrointestinal tract, organs of the chest cavity).

Infectious mononucleosis (MI)- an acute viral disorder that is caused by the Epstein-Barr virus (is a type 4 herpes virus).

The incubation period lasts from 2 weeks to 2 months.

The main symptom complex contains these features:

• an increase in the size of peripheral lymphoid areas, especially the cervical group;
• pathological processes in the nasopharynx and oropharynx;
• fever
• the occurrence of mononuclear cells in peripheral blood;
• an increase in the volume of the liver and spleen.

In addition to the main symptoms of MI, the following may be present: enanthema, exanthema, pastosity of the eyelids, puffiness of the face, rhinitis. The disorder begins acutely, with the onset of fever. Usually all symptoms develop by the end of 6-7 days.

The earliest clinical manifestations are:

• rise in body temperature;
• plaque on the palatine tonsils;
• inflammation and enlargement of the cervical lymph nodes;
• difficulty breathing.

By the end of 7-8 days from the moment the disease develops, in most people it is already possible to palpate an enlarged and compacted liver and spleen, and atypical mononuclear cells are already beginning to appear in the clinical blood test. In some individual cases, the disease develops gradually.

Complications:

1. Specific: suffocation, serous meningitis, rupture of the spleen, damage to the nervous system, trobocytopenia, agranulocytosis, hemophagocytic syndrome, infectious toxic shock.
2. Bacterial: otitis, mastoiditis, paratonsillitis, purulent lymphadenitis.

Several outcomes of an acute infectious process are possible:

• convalescence
• asymptomatic carrier or latent infection
• persistent recurrent infection:

Laboratory diagnostics:

• Peripheral blood changes: leukocytosis, moderate increase in ESR, lymphomonocytosis.
  The most important and specific sign of infectious mononucleosis are atypical mononuclear cells, the proportion of which becomes higher than 20%. They appear by the 10-14th day of illness and persist for up to 1 month.

Treatment is symptomatic. At the initial moment, bed rest should be recommended, at the stage of convalescence - restraint of physical activity. For anti-inflammatory purposes, NSAIDs are prescribed at the recommended dosage. In the acute stage of the process, the appointment of antiviral drugs (drugs of acyclovir) is not indicated.

The appointment of GCS is indicated for the development of complications (obstruction of the upper respiratory tract, thrombocytopenia, hemolytic anemia, CNS damage). Appointment of AB is indicated by the addition of secondary bacterial flora. Avoid prescribing aminopenicillins. Oral care should be guaranteed.

Symptoms and types of monocytosis

This condition - monocytosis, can be divided into several types:

1. Absolute monocytosis: it can be diagnosed when the number of cells themselves becomes higher than 0.12-0.99 * 10 9 /l.
2. Relative monocytosis: a pathological or physiological condition in which the total part of monocytes becomes higher than 3-11% of the total number of leukocytes.
   Moreover, the absolute numbers of the content of monocytes can remain within the normal range, but their level in the general leukocyte formula will be increased, which means that the number of monocytes will remain the same, but the number of other types of leukocytes will be reduced. More often this is observed with a decrease in the number of neutrophils (neutropenia) and a decrease in the number of lymphocytes (lymphocytopenia).

Absolute monocytosis is important in the detection and treatment of pathological processes in comparison with the relative, which can vary depending on trauma, stress, nutrition.

Monocytosis during pregnancy: in pregnant women, a not too high increase in the amount of leukocytes and monocytes is considered a physiological reaction of the body to a “foreign” body. And you must always keep in mind that absolute monocytosis in pregnant women should be corrected, in contrast to the relative one.

Monocytosis is not a disease, but a symptom of an underlying disease. Therefore, the picture of monocytosis will depend on the disease itself.

In the absence of any symptoms of the disease, it can be recognized by nonspecific signs:

• chronic fatigue,
• fast fatiguability
• reduced performance,
• general weakness,
• drowsiness,
• constant subfebrile temperature.

These signs can indicate a variety of diseases. During pregnancy, they are physiologically determined.

In any case, you need to see a doctor and get tested.

What is the danger of the disease?

If the content of these cells is increased in the analysis, this indicates changes in the immune system, namely the onset of immunosuppression. Therefore, the necessary prevention, and often the therapy of these disorders, is required.

Infectious diseases without etiotropic and pathogenetic therapy can lead to serious consequences, the development of complications, aggravation of existing conditions and the diseases themselves.

Untimely diagnosis of oncological processes also leads to the development of severe consequences, disability, and mortality. Therefore, it is advisable to contact specialists with advice and resolve the issue of timely diagnosis, diagnosis and therapy.

Simultaneous increase in other leukocytes against the background of monocytosis

What to do in the event of a pathology?

An increase in the level of monocytes is in any case an obligatory reason to resort to the help of a specialist - a doctor to further clarify the causes of this condition. Even a slight increase in the level of phagocytes should cause alertness.

First of all, you will need to retake a general blood test again in order to detect an increase in other indicators or only a narrow increase in monocytes. And if a repeated increase is detected, it is imperative to be examined and find out the root cause of monocytosis.