WHITE BLOOD CELL COUNT and DIFFERENTIAL

Conventional
Fluid
Absolute (Percentage)

Muramidase Serum 5-20 μg/ml

Total Leucocyte Count (TLC)

Adult 4,000 – 11,000/μl

Infants (full term, at birth) Blood 10,000 – 25,000/μl

Infants (1 year) 6,000 – 16,000/μl

Differential Leucocyte Count (DLC)

1. Total Neutrophils 2500 – 8000 (55–70%)

Neutrophils, bands 0 – 700 (0–5%)

Neutrophils, segmented 1800 – 7000 (54–65%)

2. Lymphocytes 1000 – 4000 (25–40%)

Blood
600 – 2400 cells/μL
T cells film /
(60-80%)
CBC
50 – 250 cells/μL (4-
B cells counter
16%)
3. Monocytes 100 – 700 (2–8%)

4. Eosinophils 50 – 500 (1–4%)

5. Basophils 25 – 100 (0–1%)

 Lymphocyte Assay (CD4 marker, CD4/CD8 Ratio)

CD4 493 – 1191 μL

CD8 182 – 785 μL

CD4/CD8 Ratio >1

Lavender - Top Tube.

 White blood cells are crucial to defending the body from foreign
organisms, tissues, and other substances.

 An elevated white blood cell count (leukocytosis) usually

represents an increase in one of the types of WBCs rather than an
increase in all the types of cells.

 An increased lymphocyte count is seen in infectious

mononucleosis, viral hepatitis, cytomegalovirus infection, other
viral infections, pertussis, toxoplasmosis, brucellosis, TB, syphilis,
lymphocytic leukemias, chronic bacterial infection, and multiple
myeloma.

 An increased neutrophil count may indicate acute infection,

eclampsia, gout, myelocytic leukemia, rheumatoid arthritis,
rheumatic fever, acute stress, thyroiditis, trauma.

 “Left shift” occurs when there are more than 10–12% bands or
when the sum of bands plus segmented neutrophils is >80%.
 The left shift represents an increase in the percentage of immature
band neutrophils to mature segmented neutrophils and occurs in
bacterial infection and toxemia but can also occur in acute stress
situations.

 T cells, specifically CD-4 T cells are monitored in patients who are

HIV positive.

 An increased eosinophil count occurs in allergic disorders,

parasitic infection,and Hodgkin’s disease.

 An increased monocyte count may indicate chronic inflammatory

disease, parasitic infection, tuberculosis, and viral infection.

 Decreased white blood cell count is called leukopenia.

 Decreased lymphocytes is the hallmark of AIDS. It also occurs in

acute infections, Hodgkin’s disease, leukemia, sepsis, systemic
lupus, renal failure, and radiation sickness.

 Decreased neutrophils may occur in aplastic anemia, influenza,

chemotherapy, overwhelming bacterial infection, and secondary to
medications including:
• Analgesics and anti-inflammatories
• Antibiotics
• Anticonvulsants
• Antimetabolites
 • Antineoplastics
• Antithyroid drugs
• Arsenicals
• Barbiturates
• Cardiovascular drugs
• Diuretics

WHITE BLOOD CELLS

White blood count measures the total number of white blood cells
in a given volume of blood. Since WBCs kill bacteria, this count is a
measure of the body's response to infection.

Clinical Adult Range: 4,500-11,000cu.mm

Optimal Adult Range: 5,000-8,000cu.mm
Red Flag Range: <3,000cu.mm or >13,000cu.mm

Common Causes of WBC Increase: Active Infections, Leukemia,

Childhood Diseases (Measles, Mumps, Chicken-Pox, Rubella, Etc.

Less Common Causes of WBC Increase: Asthma, Emphysema, Adrenal

Dysfunction, Intestinal Parasites, Severe Emotional Stress

Common Causes of WBC Decrease: Chronic Viral or Bacterial Infections,

Lupus (SLE)

Less Common Causes of WBC Decrease: Hepatitis, Immune

dysfunction, Chemical/Heavy metal toxicity
Nutrition Note: Decreased WBC may indicate a need for Vitamin B-12, B-
6 and folic acid.

Clinical Notes: An increase or decrease in total WBC in conjunction with

a lymphocyte count below 20 and serum albumin below 4.0 is a pattern
frequently seen in a developing neoplasm (tumor).

References:
1. Harrison's Principles of Internal Medicine, 17th edi.
2. Harsh Mohan Textbook of Pathology, 6th edi.
3. The Simplified Patient Reference Guide.
4. Lab Notes Guide to Lab and diagnostic Tests.