Impact of Corticosteroids on Leukocytosis (Nursing)

00:01 Okay. Now, this is a medication we give a lot of in the hospital, out of the hospital. We give a ton of corticosteroids.

00:10 Remember, corticosteroids are mimicking what your body naturally makes from your adrenal gland, the adrenal cortex.

00:17 That's why they're called corticosteroids.

00:20 That's what our adrenal gland normally puts out, but we give corticosteroids usually to suppress inflammation. That's what we're looking for.

00:28 But the corticosteroids will modify the leukocytosis response.

00:33 Okay, before we go on, you already probably have some ideas on why this happens.

00:38 Think about why would corticosteroids modify leukocytosis response? Well, you know that what are some of the causes of leukocytosis? Well, that means -- leukocytosis, that means elevated white cell count.

00:53 What are the reasons that my white cell count would be elevated? Oh, that would be maybe because the body's under attack for some type of infection, but corticosteroids modify that.

01:05 Well, I give corticosteroids to suppress inflammation.

01:09 So what do you think? What are corticosteroids going to do to a white cell count? Okay, let's see if your answer lines up with ours.

01:19 Okay, so corticosteroids are meant to suppress like the eosinophils, the T-lymphocytes, the mast cells, the macrophages, and the dendritic cells.

01:28 Those are the inflammatory cells. And remember, most often what we're looking for with corticosteroids is to suppress those cells, right? We want to stop that inflammatory response.

01:40 So, if we give a corticosteroid to a healthy person, the white blood cell count will increase; predominantly, the neutrophils.

01:48 But if we give a corticosteroid to a person who has a severe infection, here's what can happen.

01:55 Because the corticosteroid suppresses the inflammatory cells, you're going to see infection that can spread without us seeing an increase in the white blood cells.

02:05 Okay, so let me back that up.

02:08 As healthcare professionals, we monitor the white blood cells as a sign of infection.

02:13 But if someone's on corticosteroids, we're not going to see an increase in those white cells because the corticosteroids are artificially suppressing those cells from responding.

02:23 So, meanwhile, that infection can be running rampant throughout the patient's body, and you won't see an elevation in a white blood cell that you would normally see in a healthy person.

02:33 So keep that in mind. If you have a patient who's on corticosteroids, they might have a significant infection, and we won't see a big impact in the white cells because of that medication.

02:46 So we kind of like to say, think of corticosteroids as hiding an infection to the impact of the white blood cell count not rising.

02:55 So, how corticosteroids impact someone who might have a pretty severe infection could be that we won't see the white blood cell count respond or rise.

03:05 And so, in that way, infection is spreading, but we don't see one of our normal signs, as in the white blood cell count won't rise with that.

03:15 Now let's look at polymorphonuclear cells. We call them PMNs because that is a mouthful, polymorphonuclear cells.

03:24 So we call them PMNs or granulocytes.

03:28 So, polymorphonuclear cells have multiple nuclei.

03:31 And with your permission, I will now just call them PMNs because that is, like I said, quite a mouthful.

03:39 But now we're looking at the neutrophils, the eosinophils, and the basophils.

03:44 Remember, they're PMNs because they have multiple nuclei.

03:48 So these have multiple nuclei and we're talking about 3 types: neutrophils, eosinophils, and basophils.

03:57 So 3 of the 5 types of white blood cells have multiple nuclei.

04:03 Now, we'll go back over the suffixes again just to remind you.

04:07 "Philia" means -- it's from a Greek word -- means "philos" or true love.

04:12 So the meaning is someone or something that loves or has a fondness or attraction to or an affection for something.

04:18 You have a tendency towards something. And related terms include -philic, -philia, and -philo. Okay, so these are the suffixes.

04:26 Now let's look at that second column; -penia.

04:29 That means low. That comes from the Greek word "penia" meaning poverty or need. So that helps you remember that "penia," because it comes from poverty or need, means low.

04:40 So, if we want to break it down more, it means to lack or to have a deficiency.

04:44 It often indicates a specific type of deficiency when you add it to the end of the word.

04:49 So when you look at these 2 together, we have -philia, which means love, and of course you want more of that, and -penia, which means poverty; too low or not enough.