Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 128: A 72-Year-Old with Elevated White Blood Cell Count
Jan 9, 2025
A fascinating case of a 72-year-old man reveals elevated white blood cell counts tied to his smoking habit. Symptoms like a new cough and weight loss raise critical questions. The discussion delves into granulocytosis and its surprising links to malignancies, especially lung cancer. Misconceptions are clarified, highlighting the importance of monitoring granulocytosis as a potential cancer indicator, but with a reassuring note that it often resolves with treatment.
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Refer For Lung Cancer Evaluation
- Refer an older smoker with new cough, weight loss, and unexplained granulocytosis for lung cancer evaluation.
- Do not assume infection; pursue diagnostic testing and lung cancer screening when indicated.
Granulocytosis Can Be Paraneoplastic
- Noninfectious granulocytosis can reflect a myeloproliferative disorder or a paraneoplastic process from solid tumors.
- Tumors may secrete G-CSF, GM-CSF, or IL-6 and cause asymptomatic granulocytosis.
Granulocytosis Is Usually Infectious
- Most isolated granulocytosis is related to acute infection, not cancer.
- Less than half of patients with solid tumors have granulocytosis, so prevalence varies by cancer type.