Neutrophilia, leucocytosis

Laboratory tests

• FBC with blood film
• CRP
• Urine microscopy and culture (if urinary signs or fever without a focus)if needednon-French guidelineUrinary symptoms, or fever without an obvious source: bacteriological samples (urine, joints, fluids) are requested according to the history and examination ^[1].

In 4 to 6 weeks

• FBC with blood film (repeat)

Laboratory tests

• FBC with blood film
• CRP
• Serum creatinine
• AST
• ALT
• GGT
• Alkaline phosphatase
• Bilirubin
• LDHif needednon-French guidelineThe NHS Lothian primary care guide lists LDH, serum calcium, serum albumin and urate among the tests before referral ^[2]. The Manchester and Queensland guides detail their work-up without these tests ^[3,4]. An American review cites LDH only in the presence of bone marrow stimulation, such as haemolytic anaemia ^[1].
• Serum calciumif needednon-French guidelineThe NHS Lothian primary care guide lists LDH, serum calcium, serum albumin and urate among the tests before referral ^[2]. The Manchester and Queensland guides detail their work-up without these tests ^[3,4]. An American review cites LDH only in the presence of bone marrow stimulation, such as haemolytic anaemia ^[1].
• Serum albuminif needednon-French guidelineThe NHS Lothian primary care guide lists LDH, serum calcium, serum albumin and urate among the tests before referral ^[2]. The Manchester and Queensland guides detail their work-up without these tests ^[3,4]. An American review cites LDH only in the presence of bone marrow stimulation, such as haemolytic anaemia ^[1].
• Serum urateif needednon-French guidelineThe NHS Lothian primary care guide lists LDH, serum calcium, serum albumin and urate among the tests before referral ^[2]. The Manchester and Queensland guides detail their work-up without these tests ^[3,4]. An American review cites LDH only in the presence of bone marrow stimulation, such as haemolytic anaemia ^[1].
• BCR-ABL transcript (if blood film or FBC suggestive of CML; preferably at the haematologist's initiative)if neededLeucocytosis with myelocytes, basophilia or splenomegaly, or an FBC flagged by the laboratory as “suggestive of CML”: the diagnosis of CML rests on detection of the BCR::ABL1 fusion gene, notably by RT-PCR on peripheral blood ^[5]. NABM procedure limited to the diagnosis and follow-up of CML ^[6].
• Antinuclear antibodies (ANA)if needednon-French guidelineArthralgia, arthritis or signs of connective tissue disease: a Manchester general practice guide (2026) cites these two tests among those to consider in neutrophilia ^[3]. No French recommendation specific to neutrophilia; the American review makes the rheumatological work-up depend on the history and examination ^[1].
• Rheumatoid factorif needednon-French guidelineArthralgia, arthritis or signs of connective tissue disease: a Manchester general practice guide (2026) cites these two tests among those to consider in neutrophilia ^[3]. No French recommendation specific to neutrophilia; the American review makes the rheumatological work-up depend on the history and examination ^[1].

• Leucocytes > 100 G/L, immature cells or blasts on the film, associated cytopenia, or deterioration in general condition: haematology opinion the same day, hospital admission depending on the opinion.