Your patient has an elevated white blood cell (WBC)count but no signs or symptoms of infection.She uses albuterol and salmeterol and is currently taking a glucocorticoid.What is the most likely cause of her elevated WBC count?

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The patient exhibits no clinical signs of infection.Leukocytes,such as monocytes,macrophages,neutrophils,and basophils,are also essential to the inflammatory response and are attracted to an area of injury by the chemotactic factors identified among the mediators of inflammation.Neutrophils usually adhere ("marginate")to the capillary endothelium of storage sites in the lung.Glucocorticoids cause depletion of these stores and reduce their accumulation at inflammatory sites and in exudates.This is termed demargination and can increase the number of neutrophils in circulation as the cells leave their storage sites.An overall increase in the WBC count can be seen in patients receiving glucocorticoids.

Your Patient Has an Elevated White Blood Cell (WBC)count but No