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White Blood Cell Differential

Infection, inflammation, tissue necrosis, metabolic disorders, drugs, hormones and malignant neoplasms may cause reactive neutrophil leukocytosis. An increase in bands (left shift) is typically associated with bacterial infections. Reactive lymphocytosis may be secondary to viral infections, drugs, inflammation or stress. Eosinophilia may be seen with parasitic infestation, allergic states, drug allergies, and malignant neoplasms. Monocytosis may occur in infections (TB), inflammatory disorders and malignancy. Neoplastic increases in WBC with grossly abnormal differential counts are encountered in acute and chronic leukemia and the myeloproliferative disorders. A leuko-erythroblastic reaction (appearance of immature granulocytes and nucleated red cells in the peripheral blood) indicates bone marrow infiltration or marked bone marrow hyperplasia.

Neutropenia may be secondary to various drugs, infections, bone marrow infiltration, autoimmune disease, splenomegaly, or may be a cyclical phenomenon. Lymphopenia may be associated with acute infections, carcinoma, Hodgkin's Disease, collagen vascular disease and HIV infection.

Reference range is adults is:



Absolute #


0 - 14



45 - 78

1.7 - 6.8


15 - 47

1.0 - 3.3


0 - 12

0.2 - 0.9


0 - 7

0.0 - 0.4


0 - 2

0.0 - 0.2

Specimen requirement is one lavender top (EDTA) tube of blood. WBC differential is NOT part of the routine CBC and must ordered specifically.

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