Why Do Children Have Elevated Monocytes in Blood Routine Tests?

An increase in monocytes in blood routine tests is commonly seen in certain infections such as typhoid, tuberculosis, malaria, etc. It can also occur during acute infectious diseases or the recovery phase of acute infections. Additionally, it can be associated with certain hematological diseases such as monocytic leukemia, lymphoma, myelodysplastic syndromes, and so on.

1. Determining the presence of other bacterial infections. If a patient with hepatitis B has an elevated total peripheral blood white cell count and neutrophil count, it is important to consider whether there is a concurrent bacterial infection.

2. Assessing the presence of splenic hyperfunction. Patients with severe hepatitis B or liver cirrhosis often have splenic hyperfunction. If the total peripheral blood white cell count and platelet count are significantly reduced in HBV-infected individuals, the possibility of splenic hyperfunction should be considered, and attention should be paid to checking for the presence of liver cirrhosis.

3. Determining the need for antiviral therapy. Current antiviral drugs have varying degrees of bone marrow suppressive effects, with interferon having a particularly significant suppressive effect on the bone marrow. Therefore, regular blood routine tests should be performed before and during antiviral therapy. Generally, when the total peripheral blood white cell count is less than 2.5*10^9/L and the platelet count is less than 5*10^9/L, interferon should not be selected or discontinued, and nucleoside (acid) analogues (such as lamivudine, adefovir dipivoxil, entecavir, telbivudine, etc.) can be used for antiviral therapy.

4. Evaluating the possibility of aplastic anemia. If hepatitis B virus-infected individuals have unexplained decreases in all hematological parameters, the possibility of aplastic anemia should be considered.