The level of atypical mononuclears in a general blood test, when is it worth beating an alarm?

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Blood test

Are mononuclear cells found by a doctor in a general blood test always considered a signal of a pathological condition, and how are they indicated? What diseases increase the number of atypical cells? How to diagnose infectious mononucleosis - this will be discussed in this article.


  • The role of mononuclear cells in the body
  • The causes of the appearance in the blood of atypical cells
  • Infectious mononucleosis virus
  • Norms of indicators in children
  • How to identify mononuclears in diagnosis
  • Treatment

The role of mononuclear cells in the body

Mononuclear cells or agranulocytes are mononuclear cells responsible for immune responses. They are divided into monocytes and lymphocytes. The first when entering the system of harmful viruses and bacteria absorb them and spread the signal about the invasion of foreign cells. Lymphocytes also produce antibodies to fight infection.

Immunity to many viruses is produced by B-lymphocytes, circulating in the body for six months or more. The immune memory is formed, so that at the next meeting with pathogens the disease is transferred easier.

There are groups of viruses that can enhance the synthetic activity of lymphocytes, which subsequently leads to the formation of atypical mononuclears. The size of the cells increases 4-5 times, when viewed under a microscope, a wide cytoplasm and a small nucleus are noticeable.

Atypical mononuclear cells in a general blood test often become a signal of serious illnesses in both adults and children.

Atypical cells can talk about the disease, so it is important to carry out diagnostics

The causes of the appearance in the blood of atypical cells

The emergence of atypical mononuclears is facilitated by diseases that disable the immune system of the body. Among the most probable causes are:

  • diseases of a viral nature (inf. mononucleosis, acute respiratory viral infection, influenza, chickenpox, cytomegalovirus infection, Botkin's disease, HIV infection, whooping cough);
  • diseases of a bacterial nature (iersiniosis, chlamydia, tuberculosis, brucellosis);
  • infection with helminths;
  • oncology;
  • individual intolerance of medications;
  • diseases of an autoimmune type (lupus erythematosus, vasculitis).

Infectious mononucleosis virus

More often than other factors, the appearance of pathological cells is provoked by the Epstein-Barr virus. Infection occurs through the air in communication with the patient or carrier. Possible placental way of transmission from mother to child and as a result of unprotected sexual intercourse.

Viral disease is more likely to affect adolescents and young adults. According to statistics, by the age of 25 almost 90% of the population had suffered an infectious mononucleosis caused by this virus.

A characteristic feature is the defeat of lymphoid tissue in the disease: tonsils, liver, spleen, all lymph nodes.

Symptoms of mononucleosis:

  • increase in body temperature to 3, -3, ° C;
  • painful sensations when swallowing;
  • symptoms of general intoxication;
  • plaque on the tonsils;
  • nasal congestion, snoring;
  • enlarged lymph nodes, especially cervical;
  • yellowed sclera and skin;
  • an increase in the size of the liver and spleen.

The incubation period of the disease can last from 5 days to 2 months. In terms of the combination of symptoms, the clinical picture resembles angina.

Angina + strong swelling of the nasopharynx + enlargement of the liver + mononuclears in the blood = mononucleosis. The virus multiplies by dividing cells at high speed, but in the external environment it is unstable. The disease in most people is mild.

Characteristic symptomatology of the disease for most children and adults

That is why the diagnosis of it is difficult. The analysis of blood sampling on mononuclear cells can be appointed by a doctor with a diagnostic purpose when the patient first contacts him.

Norms of indicators in children

The norm of increased in the amount of agranulocytes in the blood of the child is 0-1%. Insignificantly (up to 10%), their number increases with autoimmune diseases, tumors. The highest level of atypical mononuclear cells in the OAK in a child is present in infectious mononucleosis. Sometimes their number exceeds 50% of white blood cells.

To confirm the diagnosis, the blood is taken twice at intervals of five days. At the initial stage of the disease, the number of atypical cells is 10%. In a week the number reaches a maximum - 60-80%.

How to identify mononuclears in diagnosis

If atypical mononuclear cells are detected in the JAB, their designation may be treated by a physician in percentage or SI units. Depending on the preliminary diagnosis and the patient's condition, he can give preference to several methods:

  1. UAC.

These blood cells are found when deciphering the leukocyte formula. The indicator table includes all types of cells. The formula contains the percentage of all leukocytes, separately monocytes and lymphocytes.

A positive blood test for atypical mononuclears confirms the diagnosis, determines the severity of the infection and the effectiveness of the prescribed treatment.

Important! To detect atypical cells in this way is possible only at an early stage, two weeks after infection with the virus.

You can take the analysis in the medical diagnostic center.

  1. Agglutination reaction.

Hemotest is the detection in the blood serum of a patient's antibodies to the pathogen by agglutination. The effectiveness of the method is 90%.

  1. Additional diagnostic methods.

Ancillary diagnostic methods are urine analysis - a high amount of bilirubin, ALT, AST is detected in biochemical analysis. This is due to increased secretion of bile. Subsequently, the skin and sclera of the eyes turn yellow. The doctor can prescribe an ultrasound of the abdominal organs, perform a bone marrow or lymph node puncture.

The blood of the in vitro (test in vitro)

The process of recovery after a long illness is quite long and time consuming. During the month, asthenia is observed - increased irritability, fatigue, sweating. By the end of the recovery period, the level of analyzes for mononuclear cells is normalized.

Pay attention, if in a month the number of pathological cells does not return to normal, you need to consult a doctor oncologist. If you find atypical mononuclears in a general blood test in a child, you need to put it on the account of an oncologist.

The virus is present in the lymphocytes throughout life, but in a passive state. Its activation occurs only in the case of an autoimmune disease or HIV infection due to a drop in immunity.


Treatment of infectious mononucleosis is symptomatic. Peace, fresh air, abundant drink, treatment of the oropharynx, nose wash - standard therapy of a viral infection. After the illness, the child remains weakened for a long time, therefore the doctor prepares a medical pilot from vaccinations for 6-12 months.

Contraindicated in the recovery period, long-distance travel with a change of climate, you can not sunbathe. Antibiotics are prescribed in case of bacterial infection: otitis media, pneumonia.

Timely contact with a doctor guarantees successful treatment, minimizes the risk of complications.

In the proposed video, this is told in more detail:

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