The White Blood Cell (WBC) differential is typically ordered in conjunction with the Complete Blood Count (CBC).

By looking at and differentiating the different types of WBC’s, it can show the body’s ability to fight infection. Also based on which WBC is increased or decreased, it can indicate which type of infection (bacterial, viral or parasitic) you may be fighting.

The WBC differential is also useful for determining or identifying the various types of leukemias.

The WBC differential can be determined by various types of hematology analyzers or performed manually by examining a stained blood smear microscopically.

The results are reported as absolute numbers (expressed as # of cells x 109/L) or relative numbers (expressed as a %).

The different types of white blood cells are as follows:

? Segmented neutrophils

These usually increase in bacterial infections or other inflammatory response. It can also be very elevated in certain leukemias.

? Band neutrophils

This is younger form of the neutrophil. An increase in band neutrophils or more immature neutrophils indicate possible blood disorders.

? Lymphocyte

Increases can be seen in viral infections and certain types of leukemia. Decreases can be seen in certain autoimmune conditions or HIV.

? Monocytes

Increases can be seen in leukemias, malignant disorders and tuberculosis.

? Eosinophils

Increases can be seen in parasitic infections and allergies.

? Basophils

Increases can be seen in leukemias and Hodgkins disease.

Examination of the WBC differential smear can also show alterations is the WBCs such as toxic granulation and other abnormal inclusion bodies.

In addition to examination and differentiation of WBC’s, examination of the blood smear can show abnormalities in red blood cell morphology. This is useful in the diagnosis of the various types of anemias and other disorders.

Platelets can also be looked at for estimation of quantity and appearance.

What is a “normal” or reference range? It is a set of values of some measurement that a physician or other health professional can use to interpret a set of results for a particular patient. You will see the reference ranges on the lab report next to your lab result. Your lab result will be low, normal or high based on this range.

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