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Leukocytes Differential, Blood

The purpose of white blood cells is to protect the body from the threat of foreign agents, such as bacteria. All blood cells, including white blood cells, red blood cells, and platelets, come from a common stem cell. The differentiation of blood cells takes place in the bone marrow.

Phagocytic white blood cells, which include granulocytes and monocytes, play an important role in the process of phagocytosis and digestion of cell debris. The granulocytes were so named because of their granular appearance. These cells are also called polymorphonuclear because of their multilobular nuclei. The three types of granulocytes are neutrophils, eosinophils, and basophils. Monocytes along with lymphocytes are considered mononuclear leukocytes (or non-granulocytes) since their nuclei are not multilobular.

Neutrophils are the first white blood cells to reach the site of inflammation. They begin their work by cleansing the area of ​​cellular debris through the phagocytosis process. Neutrophils have a life span of around 4-5 days. Mature neutrophils are distinguished by the hyper-lobular appearance of their nuclei (hypersegmented neutrophils), possessing from two to five lobes and which increase (right shift) during pathological conditions. Immature neutrophils do not have a lobular appearance of their nuclei, they are called neutrophils with rod-shaped nuclei and increase their number (left shift) during conditions that increase white blood cell production.

Eosinophils play an important role in the defense against parasitic infections. They can also phagocytize cellular remnants, but to a lesser extent than neutrophils, and in the later stages of inflammation. They also play a role in allergic reactions.

Basophils release histamine, bradykinin, and serotonin when triggered by injury or infection. These substances are important for the inflammatory process as they increase capillary permeability and thus increase blood flow to the affected area. Basophils are also involved in allergic reactions. In addition, the granules on the surface of the basophils secrete the natural anticoagulant, heparin.

Monocytes, which live for months or even years, are not considered phagocytic cells when they circulate in the blood. However, when they remain in tissues for several hours, the monocytes mature into macrophages, which are phagocytic cells.

Lymphocytes, including T lymphocytes (T cells) and B lymphocytes (B cells), mature in lymphoid tissue and migrate between blood and lymph. Lymphocytes have a life span of days or years, depending on their type.

The measurement of white blood cells and their type is included in the Complete Blood Count and includes two sections. "White blood cell count" means the total and the absolute number of white blood cells (leukocytes) and their types in 1 mm3 of blood. The other section comprises basophils, eosinophils, lymphocytes, monocytes, and neutrophils. Since the percentages are always equal to 100%, an increase in the percentage of one type of white blood cell causes a mandatory decrease in the percentage of at least one other type of white blood cell.

"Left shift" means that there is an increased number of immature neutrophils in peripheral blood. Neutrophils are usually depicted from the left (young cells) to the right (mature cells). A low number of left-shift total white blood cells indicates a recovery following bone marrow suppression or an infection of such intensity that the demand for neutrophils in the tissues is greater than the ability of the bone marrow to release them into circulation. A high number of left-shift total white blood cells indicates increased neutrophil release from the bone marrow in response to an infection or inflammation.

"Right shift" means that neutrophils have more nuclear lobes than normal. This happens in liver disease, Down syndrome, megaloblastic and pernicious anemia.

Causes of White Blood Cells Increase

Abscess, actinomycosis, amputation, Andersen's disease, anemia (acquired, haemolytic), anorexia, anoxia, anthrax, appendicitis, bacterial infections, blastomycosis, bronchitis, burns, chickenpox, acute cholecystitis, cholelithiasis, cholera, cirrhosis (with necrosis), colon cancer, epileptic seizures, Crohn's disease, laryngitis, Cushing's syndrome, cytomegalovirus infection, dengue fever, diphtheria, rupture of aortic aneurysm, diverticulitis, diverticulosis, dysproteinemia, eclampsia, electroconvulsive therapy, emotional stress, empyema, endocarditis, Epstein-Barr virus infection, embryonic erythroblastosis, exercise, ultraviolet radiation, fatty liver, fever of unknown origin, G6PD deficiency, gangrene, glomerulonephritis (metastreptococcal), gout (acute), heart transplant rejection, bleeding, hepatitis (alcoholic), hepatoma, hookworm, Hodgkin's disease, idiopathic myelofibrosis, infection (bacterial, parasitic), infectious mononucleosis, intestinal obstruction, ketoacidosis, lactic acidosis, Legionnaires' disease, leukemia, leukocytosis, lymphoma, meningitis, menstruation, myocardial infarction, myocarditis, pancreatitis, peritonitis, pneumonia, poisoning (arthropods, chemicals, minerals, other poisons), polycythemia vera, post-operative stress, pregnancy, paroxysmal tachycardia, proleukemia, retroperitoneal fibrosis, rheumatic fever, sepsis, shock, smallpox, stress, pyogenic cholangitis, systemic lupus erythematosus, tonsillitis, toxic shock syndrome, transfusion reaction, trauma, tuberculosis, tularemia, tumor necrosis, ulcers, ultraviolet radiation, uremia, yellow fever, Wegener granulomatosis, Weil disease. Medications: Allopurinol, anesthetics, atropine sulfate, barbiturates, diethylcarbamazine, epinephrine, erythromycin, steroids, streptomycin sulfate, sulfonamides. Herbs or natural remedies that increase stimulating factor (GCSF) as well as those that increase lymphocytes include Viscum album and Echinacea purpurea.

Causes of Neutrophils Increase

Acute infections, allergies, anemia, anoxia, stress, appendicitis, asthma, burns, cancer, chickenpox, cholecystitis, cholera, colitis, Cushing's syndrome dermatitis, diabetic acidosis, diphtheria, diverticulitis, diverticulosis, eclampsia, G6PD deficiency, gangrene, gout, hemorrhage, inflammation, ketoacidosis, pregnancy and childbirth, leukemia, leukocytosis, lymphoma, meningitis (pyogenic), myocardial infarction, osteomyelitis, otitis media, pancreatitis, panic, peritonitis, pernicious anemia, pneumonia, poisoning (carbon monoxide, lead, mercury, arsenic, turpentine), polycythemia vera, postoperative stress, pulmonary infarction, pyelonephritis, rheumatic fever, rheumatoid arthritis, salpingitis, scarlet fever, sepsis, smallpox, smoking, thyroiditis, tonsillitis, transfusion reaction, typhoid, uremia. Medications: Acetylcholine, benzene, carbon monoxide, casein, chloropropamide, corticosteroids, corticotropin, ringworm, epinephrine, ethylene glycol, histamine, heparin, insect poisons, lead, lithium, mercury, potassium chloride and turpentine.

Causes of Eosinophilic Increase

Addison's disease, allergies, kidney disease, asthma, brucellosis, cancer (bone, brain, ovarian, testicular), chorea, coccidioidomycosis, dermatitis, diverticulitis, diverticulosis, eczema, gangrene, allergic rhinitis, Hodgkin's disease, leprosy, leukemia (chronic granulocytic), leukocytosis, Löffler syndrome, malaria, metastatic carcinoma, parasitic infections, pemphigus, pernicious anemia, phlebitis, polycythemia vera, psoriasis, jaundice-induced pruritus, radiotherapy, rheumatoid arthritis, rhinitis, sarcoidosis, sickle cell anemia, splenectomy, thrombophlebitis, tuberculosis, ulcerative colitis, Sjogren's syndrome. Medications: Antibiotics (associated with allergic reactions), allopurinol, aminosalicylic acid, antispasmodics, cephalosporins, chlorpropamide, digoxin, heparin, imipramine, methotrexate, nitrofurantoin, penicillin, phenothiazine, procainamide, procarbazine, propranolol, quinidine, streptomycin, sulphonamides, tetracycline.

Causes of Basophil Increase

Allergic reaction to food/medicine/inhaled substances, chickenpox, chronic myelogenous leukemia, erythroderma, anemia with Heinz bodies, Hodgkin's disease, hypothyroidism, radiation, leukocytosis, myelofibrosis, myxedema, nephrotic syndrome, periarteritis, polycythemia vera, sinusitis, smallpox, splenectomy, ulcerative colitis, urticaria. Medications: Antithyroid, desipramine, estrogens.

Causes of Lymphocyte Increase

Brucellosis, cytomegalovirus infection, diverticulitis, diverticulosis, endocarditis, hepatitis, Hurler syndrome, infectious mononucleosis, leukocytosis, lymphocytic leukemia, pertussis, syphilis. Medications: Aspirin, haloperidol, lead poisoning, levodopa, phenytoin, tetrahydrochloride poisoning.

Causes of Monocyte Increase

Brucellosis, carbon disulfide poisoning, Epstein-Barr virus infection, Hodgkin's disease, leukemia (AML, CML), leukocytosis, multiple myeloma, rheumatoid arthritis, salmonellosis, sarcoidosis, syphilis, systemic lupus erythematosus, tetrahydrochloride poisoning, tuberculosis, ulcerative colitis. Medications: Haloperidol, mesuximide.

Causes of White Blood Cell Decrease

Agranulocytosis, acquired immunodeficiency syndrome (AIDS), alcoholism, anaphylactic shock, anemia (aplastic, malignant), amyloidosis, anorexia nervosa, anthrax, arsenic poisoning, brucellosis, cachexia, chemical toxicity, chemotherapy, cirrhosis, dengue fever, systemic lupus erythematosus, Felty syndrome, Gaucher disease, heavy chain disease, hepatitis (infectious, viral), hypersplenism, hypothermia, idiopathic myelofibrosis, Hodgkin's disease, infection (severe bacterial, viral), influenza, Legionnaires' disease, leishmaniasis, leukemia (some forms), leukopenia, lymphoma, measles, mononucleosis, myxedema, paratyphoid, pharyngitis, Pneumocystis pneumonia, preleukemia, protein therapy, psittacosis, Q fever, radiation therapy, renal trauma, rheumatic fever, rubella, neonatal sepsis, shock, Sjogren's syndrome, stomatitis, strongyloidiasis, toxoplasmosis, tuberculosis, tularemia, typhoid fever. Medications: Acetaminophen, aminoglutethimide, aminopyrine, antibiotics, antineoplastics, anti-thyroid, arsenic, aurothioglucose, bismuth, chloramphenicol, chloroquine phosphate, diazepam, diethylcarbamazine, ethotoin, frusemide, immunosuppressants, meprobamate, methyldopa, methsuximide, phenothiazines, phenylbutazone, phenytoin, primidone, hydrochloride procainamide, quinacrine hydrochloride, quinine sulfate, sulfonamides, vitamin A.

Causes of Neutrophil Decrease

Acromegaly, Addison's disease, agranulocytosis, anaphylactic shock, anorexia nervosa, aplastic anemia, brucellosis, cachexia, carcinoma, Chediak-Higashi syndrome, chemotherapy, cirrhosis, dengue fever, Felty syndrome, folic acid deficiency, Gaucher disease, hypersplenism, pituitary dysfunction, hypothyroidism, infections, infectious hepatitis, infectious mononucleosis, influenza, iron deficiency anemia, Kala-azar, malaria, measles, mumps, myelofibrosis, myeloma, paratyphoid, paroxysmal nocturnal hemoglobinuria, malignant anemia, pneumonia, psittacosis, radiotherapy, Rocky Mountain fever, rubella, measles, sarcoma, sepsis, thyrotoxicosis, tularemia, typhoid fever, vitamin B12 deficiency, yellow fever. Medications: Alcohol, aminophylline, antipyrine, aminopyrine, ampicillin, male, aspirin, barbiturates, carbimazole, cephalothin, chemotherapeutic agents, chloramphenicol, chlorpromazine, chlorpropamide, diazepam, dinitrophenol, diuretics, electroconvulsive, gold salts, imipramine, indomethacin, isoniazid, mephenytoin, 6-mercaptopurine, methicillin, p-aminobenzoic acid, penicillin, phenacetin, phenylbutazone, phenylhydrazine, phenytoin, procainamide, quinine, streptomycin, sulfonamide, sulfonamides, tolbutamide, tripelennamine hydrochloride, urethane.

Causes of Eosinophil Decrease

Acromegaly, anemia (aplastic), coccidioidomycosis, congestive heart failure, Cushing's syndrome, systemic lupus erythematosus, eclampsia, Goodpasture's syndrome, hypersplenism, infections, infectious mononucleosis, schistosomiasis, stress. Medications: Adrenocorticotropic hormone, corticotropin, epinephrine, glucocorticoids, methysergide, niacin, niacinamide, procainamide, thyroxine.

Causes of Basophil Decrease

Acute infection, anaphylaxis, Cushing's syndrome, hyperthyroidism, ovulation, pregnancy, radiation therapy, thyroid toxicity, stress. Medications: Chemotherapeutics, corticosteroids, corticotropin, procainamide, thiotepa.

Causes of Lymphocyte Decrease

Aplastic anemia, Cushing's syndrome, Hodgkin's disease, immunoglobulin deficiencies, leukemia (chronic granulocytic, monocytic), lymphosarcoma, renal failure, systemic lupus erythematosus, thymic hypoplasia in children, uremia. Medications: Asparaginase, chlorambucil, cortisone, epinephrine, glucocorticoids, lithium compounds, mechlorethamine, niacin, lymphoid tissue radiotherapy.

Causes of Monocyte Decrease

Aplastic anemia, hairy cell leukemia



Important Note

Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".

Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.

At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.

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