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Why Get Tested?
To help determine the cause of abnormal results on a white blood cell (WBC) count; to help diagnose and/or monitor an illness affecting your immune system, such as an infection or inflammatory condition, or cancers that affect your white blood cells, such as leukemia
When To Get Tested?
As part of a complete blood count (CBC), when you have a routine health examination; when results of a CBC fall outside the reference range; when you have any number of signs and symptoms that may be related to a condition affecting white blood cells, such as infection, inflammation, or cancer; when you are receiving treatment that is known to affect WBCs, such as chemotherapy
Sample Type:
EDTA Whole Blood (Purple)
Fasting :
AS PER DOCTOR
Report Delivery:
within 48 Hrs of Test Schdule
Components:
10 Observations

Tests Detail

Observations Included

Monocytes *

Absolute Neutrophils *

Absolute Lymphocytes *

Absolute Eosinophils *

Lymphocytes *

Neutrophils *

Eosinophils *

Basophils *

Absolute Monocytes *

Absolute Basophils *

The Test marked with (*) are in our NABL Scope.

Sample Report

Test Name	Differential Count (DC)
Report Availability	within 48 Hrs of Test Schdule
Code	H2026
Category	R-Routine
Schedule	Daily
TAT*	0
Tested At*	NPL
Method	Semiconductor Laser Flocytometry/ Light Microscopy,Calculated
Brief Description	Freshly prepared peripheral smear should accompany. Clinical history is mandatory

*Reporting TAT in days
for the samples recieved by 4PM

*0 = Same Day, 1 = Next Day, 2 = 2nd Day,
3 = 3rd Day So on from Schedule

*NPL : Tested @ nirAmaya Pathlabs
NRL : Tested @ NPL Outsource lab

Also Known As:
Leukocyte Differential Count Peripheral Differential WBC Count Differential Diff Blood Differential
Formal Name:
White Blood Cell Differential
Sample Instructions:
A blood sample drawn from a vein in your arm or by a fingerstick (children and adults) or heelstick (infants)
Test Preparation Needed?
None
What Is Being Tested?
White blood cells (WBCs), also called leukocytes, are cells that circulate in the blood and the lymphatic system that help protect the body against infections. They are an important part of the body's immune system and also have a role in inflammation, allergic responses, and protection against cancer. A WBC differential totals the number of each of the different types of WBCs in a person's sample of blood. There are five types of white blood cells, each with different functions. The differential reveals if the cells are present in normal proportion to one another, if the number of one cell type is increased or decreased, or if abnormal and/or immature cells are present. This information is helpful in diagnosing specific types of illnesses that affect the immune system and the bone marrow. A differential may be performed in conjunction with a complete blood count (CBC), a test often used as a general health check, or it may be performed in follow-up to abnormal results on a CBC. Most often, a differential is performed on an automated blood analyzer but also may be performed manually by a trained laboratorian who examines a blood smear under a microscope. The values are typically reported as absolute numbers of cells but may be expressed as the relative percentages of the total number of WBCs. White blood cells develop from precursor cells produced in the bone marrow. The five different types of WBCs include: Granulocytes—these white blood cells have granules in their cytoplasm. The granules contain chemicals and other substances that are released as part of an immune response. The three types of granulocytes include: Neutrophils (neu) normally make up the largest number of circulating WBCs. They move into an area of damaged or infected tissue, where they engulf and destroy bacteria or sometimes fungi. Eosinophils (eos) respond to infections caused by parasites, play a role in allergic reactions (hypersensitivities), and control the extent of
How Is It Used?
The white blood cell differential is often used as part of a complete blood count (CBC) as a general health check. It may be used to help diagnose the cause of a high or low white blood cell (WBC) count, as determined with a CBC. It may also be used to help diagnose and/or monitor other diseases and conditions that affect one or more different types of WBCs. The five types include: neutrophils, lymphocytes, monocytes, eosinophils and basophils. (For more details on these, see the "What is being tested?" section.) The differential totals the number of each type and determines if the cells are present in normal proportion to one another, if one cell type is increased or decreased, or if immature cells are present. This information is useful in helping to diagnose the specific cause of an illness, such as: Infections caused by bacteria, viruses, fungi or parasites Inflammation Allergies, asthma Immune disorders (e.g., autoimmune disorders, immune deficiency) Leukemia (e.g., chronic myeloid leukemia, chronic lymphocytic leukemia) Myelodysplastic syndrome Myeloproliferative neoplasms (e.g., myelofibrosis) Some diseases trigger a response by the immune system that causes an increase in certain types of WBCs. A differential may give clues to the specific cause of that immune response. For example, it may help determine whether an infection is caused by bacteria or by viruses. Other conditions affect the production of certain WBCs by the bone marrow or their survival in the circulation, resulting in either an increase or decrease in their number. A differential informs the healthcare provider as to which type of WBC is low or high. An abnormal differential result may be followed by other tests such as a blood smear, bone marrow biopsy, chromosome analysis, or immunophenotyping (e.g., flow cytometry). These tests can reveal the presence of abnormal and/or immature populations of WBCs.
When Is It Ordered
The differential is often performed as part of the complete blood count (CBC), which may be ordered at the time of a routine health exam. A differential may be included as part of the CBC when someone has general signs and symptoms of an infection and/or inflammation, such as: Fever, chills Body aches, pain Headache A variety of other signs and symptoms, depending on the site of suspected infection or inflammation Testing may be performed when there are signs and symptoms that the healthcare provider thinks may be related to a blood and/or bone marrow disorder, autoimmune disease or other immune disorder. If a differential is not done at the same time as a CBC, it may be ordered when results from the CBC are not within the reference ranges.
What Does The Test Result Mean?
The results indicate the number and/or the percentage of each type of white blood cell that is present in a person's sample of blood. Results of a differential are usually reported as absolute values of the five types of WBCs and/or may be reported as a percent of the total number of WBCs. Absolute values are calculated by multiplying the total number of WBCs by the percentage of each type of white cell. This information can aid in diagnosing illness and monitoring therapy. Neutrophils typically make up the highest number of WBC, followed by lymphocytes, then monocytes, eosinophils and basophils. Care must be taken when interpreting the results of a differential. A healthcare provider will consider an individual's signs and symptoms and medical history as well as the degree to which the cells are increased or decreased. A number of factors can cause a transient rise or drop in the number of any one type of cell. A persistent increase or decrease will usually prompt further testing to determine the cause. The following table gives some examples as to what the results of a differential may indicate: Possible Causes of High and Low WBC Differential Results Type of WBC Abbreviations Examples of causes of a high count Examples of causes of a low count Neutrophils (Absolute neutrophil count, percent neutrophils) Neu, Polys, PMNs, ANC, % Neu Known as neutrophilia Acute bacterial infections and also some infections caused by viruses and fungi Inflammation (e.g., inflammatory bowel disease, rheumatoid arthritis) Tissue death (necrosis) caused by trauma, major surgery, heart attack, burns Physiological (stress, rigorous exercise) Smoking Pregnancy—last trimester or during labor Chronic leukemia (e.g., myelogenous leukemia) Known as neutropenia Myelodysplastic syndrome Severe, overwhelming infection (e.g., sepsis--neutrophils are used up) Reaction to drugs (e.g., penicillin, ibuprofen, phenytoin, etc.) Autoimmune disord
Is There Anything Else I Should Known?
Long-term use of steroids or long-term exposure to toxic chemicals (such as lye or insecticides) can increase the risk of an abnormal differential. Can a white blood cell (WBC) differential be performed on samples other than blood? Yes. WBC differentials, along with WBC counts, may be performed on many different types of body fluids. A common reason that this is done is to more directly assess one area of the body that may be infected or inflamed. For example, if meningitis is suspected, then a WBC count plus differential may be performed on a sample of cerebrospinal fluid (CSF). Many other examples are listed in the article on Body Fluid Analysis. If I have an abnormal result on my WBC differential, what other tests might my healthcare provider order? Other general tests to check your health may include a comprehensive metabolic panel (CMP). Depending on your signs, symptoms, medical history, physical exam and suspected condition, your healthcare provider may choose to order a variety of other tests. A few general examples include: • Bacterial infection: a culture of the affected area (e.g., urine culture, sputum culture, blood culture), strep test • Viral infection: tests for mononucleosis, EBV • Inflammation: CRP, ESR • Autoimmune diseases: ANA • Allergies: Allergy tests • Leukemia or other bone marrow disorders: Bone marrow biopsy, immunophenotyping, chromosome analysis My report mentions a "left shift." What does this mean? A "left shift" is a phrase used to note that there are a high number of young, immature white blood cells present. Most commonly, this means that there is an infection or inflammation present and the bone marrow is producing more WBCs and releasing them into the blood before they are fully mature. This is a natural immune response to infection and inflammation. My complete blood count (CBC) report includes a result for immature granulocytes (IG). What are they? Some automated hematology analyzers report the total number of immature

Differential Count (DC)

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