Neutrophils: the norm, the causes of increased and decreased results in a child or adult. Normal level of neutrophils in the blood and the reasons for its change Number of neutrophils
In the general blood test, an important role is played by the assessment of leukocytes and, in particular, neutrophils. These cells largely determine our immunity, so it is simply necessary to monitor their condition. The human body responds by changing the number of neutrophils to a variety of disorders. That is why it is simply necessary to know the rate of neutrophils in a blood test. However, this is not enough: it is necessary to understand the reasons for possible deviations.
All neutrophils can be divided into stab, or young, and segmented, or mature. Even earlier forms are called young, but they should not be found in a blood test in healthy people. The difference between stab and segmented forms of neutrophils lies in the structural features of the nucleus. In the first case, it really looks like a stick, and in the second case it is divided into segments. During the analysis, the laboratory assistant clearly sees this difference under a microscope.
The norm of neutrophils in the blood is the same in women and men. This is 2-5% of all leukocytes for stab and 55-67% for segmented.
For children, these figures are slightly different:
- in infants: an average of 3.5% and 32.5%,
- in a child at 4-5 years old: 4% and 41%,
- in a child aged 6-7 years: 3.5% and 45.7%,
- in a child at 9-10 years old: 2.5% and 48.5%,
- in a child at 11-12 years old: 2.5% and 49%,
- in children after 13 years: 2.5% and 58%.
Such a difference in blood counts in a child and an adult is due to the different intensity of hematopoietic processes, as well as the imperfection of the immune system in children. The fact that these standards are the same for men and women indicates that the process of neutrophil formation does not depend on sex hormones.
However, there is one thing: during pregnancy in women, the level of neutrophils increases markedly. This is due to the fact that the female body is significantly rebuilt during the period of expectation of the child, and homeostasis changes. In the first trimester of pregnancy, the percentage of neutrophils in the blood of women increases by about 10%, and by the last trimester this figure reaches 69.6%.
To monitor the dynamics of changes, a woman during pregnancy should regularly visit a doctor and take a blood test. Timely detected deviations in the body of women who are expecting children allow them to be corrected as early as possible, which means protecting the unborn child from adverse effects.
Neutrophilic leukocytes live an average of 13 days. Like all blood cells, they are produced in the red bone marrow and then enter the general circulation. After neutrophils pass from the blood into the tissues, they quickly die. On average, about one hundred billion neutrophils are formed in our body per day (this figure is approximately the same for men, women and children).
When describing CBC results, neutrophils are sometimes referred to as neut or neu. Most often, such a reduction is issued by an apparatus that automatically counts blood cells. In manual analysis, as a rule, one can find a compressed record of s / s (segmented) and s / s (stab).
Before moving on to the causes of neutrophil deviations from the norm, it is necessary to say a few words about their function in the body. In short, this is participation in immune reactions. However, the same applies, for example, to lymphocytes. Therefore, the role of neutrophils requires some clarification. Their significance for the immune system is determined by the fact that they carry out phagocytosis, have a cytotoxic effect, and also secrete lysosomal enzymes and biologically active substances. Not a single inflammatory reaction can do without neutrophils.
Reasons for deviations
An increase in the percentage of neutrophils in the blood can be physiological and pathological. In addition to pregnancy in women, physiological changes include physical activity, psycho-emotional stress, and even food intake (due to the latter reason, the analysis must be taken on an empty stomach). Pathological factors leading to the fact that the total level of neutrophils is increased are extremely diverse.
The most common causes are bacterial infections and inflammatory processes of any etiology (including those due to trauma, surgery, intoxication). In addition, such a picture in the blood test occurs with any tissue damage, for example, with myocardial infarction or kidney infarction. Also, neutrophilia can be caused by hormonal disorders, and in particular, thyrotoxicosis, and the presence of oncological diseases in the early stages.
This blood picture is characteristic of some types of leukemia. As a rule, uncharacteristic young neutrophils appear in the blood, due to which the decoding of the analysis is not particularly difficult. The unpleasant thing is that leukemia is getting younger, and more and more often it is found not in middle-aged men and women, as it was before, but in children. However, with timely diagnosis, the child can be saved, and for this, a competent decoding of the blood test is important.
The most common cause of a decrease in the total number of neutrophils are viral infections, such as measles, rubella, influenza, hepatitis, etc. Variants with hematopoiesis suppression are also possible. It occurs when there is a lack of folic acid and vitamin B 12 in the body, possibly with acute leukemia, poisoning with benzene or aniline, massive irradiation. In rare cases, a genetic disorder of hematopoiesis is detected, which manifests itself in children from the very first days of life.
Another factor leading to a decrease in neutrophils is immune disorders that occur in diseases such as rheumatoid arthritis, systemic lupus erythematosus, etc. It is possible to suppress immunity against a background of prolonged bacterial infection. In this case, low neutrophils do not indicate recovery, but show that the disease has become severe. In addition, there is a redistributive variant of neutropenia, when, when deciphering a blood test, it is found that neutrophils are lowered due to their low content in the sample taken for analysis, but in fact their total amount in the blood is within the normal range.
Such a discrepancy occurs when the blood flow is redistributed in favor of some organ (for example, in favor of the spleen in splenomegaly). Anaphylactic shock can serve as a vivid illustration of redistributive neutropenia.
As a rule, when deciphering a clinical blood test, attention is paid not only to the total content of neutrophils, but also to the ratio of the two main fractions - stab and segmented. Doctors always look not only at the neut (neu) values, but also at the individual numbers for each class. This is due to the fact that there are pathologies in which the total number is normal, but there is a shift in the ratio of cells in one direction or another. But this is a separate big topic.
However, even in itself, the changed number of neutrophils can say a lot when deciphering a blood test. Most often, when such deviations are detected, an experienced doctor, based on the clinical picture and laboratory data, can already assume the nature of the existing pathology, and all further studies are aimed at confirming the existing assumption.
Content
Most of the white blood cells are neutrophils. Their function is very important for the human body - the destruction of pathogenic bacteria in the blood, body tissues, while leukocyte elements die themselves. There is an indicator of the norm, and when tests reveal a low content of neutrophils in the blood, this indicates a possible development of the disease.
Neutrophils are normal
This indicator is designated neut in a wbc-type blood test, two subgroups of these cells are distinguished. Inside the body, 2 phases of maturation of granulocytes are distinguished, this process takes place in the bone marrow. Initially, the cells are called myelocytes, after which they turn into metamyelocytes. They are formed exclusively inside the bone marrow and do not enter the blood, so wbc analysis should not detect them.
At the next stage, they look like a stick, from which the name of the form came from - stab. After maturation, the cells acquire a segmented nucleus, at this stage segmented leukocytes are formed. The rate of neutrophils in the blood is determined by these two types of cells: wbc analysis indicates the percentage of the total. From the total number of leukocytes, the ratio of each type is calculated: this is called the leukocyte formula.
Stab neutrophils are normal
The indicators of these cells do not depend on the gender of the person; the main criterion for assessing the normal indicator is the age of the patient. This is one of the types of cells that are taken into account in the leukocyte formula. If stab neutrophils are studied, the norm differs significantly in infants and a child who is already a week old. It should be remembered that this is only a part of the total content of leukocyte cells. Normal values are shown in the table:
|
Quantity (% stab) |
|
|
baby |
|
|
7 days from birth |
|
|
preschooler |
|
|
Adult |
Segmented neutrophils are normal
This is the second form of leukocyte cells that are taken into account in the analysis. This is the second element that is taken into account in the leukocyte formula. In the transcript of the general analysis, segmented neutrophils will be indicated - the norm is:
Neutrophils - the norm in children
After conducting a general analysis, the doctor pays attention to the number of leukocytes. If they are lowered or increased, this indicates the possible development of some kind of pathology. The deviation of the indicators of one of the types of leukocytes will indicate a specific type of disease. The main task of these cells is the fight against fungal, viral diseases. Doctors have established the norm of neutrophils in the blood of children, which indicates the absence of pathologies.
- In the first days of life, the child should have 50-70% segmented and 5-15% stab.
- The number of these cells by the end of the first week should be 35-55% and 1-5%.
- After two weeks, the rate of stab cells will be 1-4%, and segmented - 27-47%.
- By the end of the month of life, the child will have 1-5% stab, 17-30% segmented, and by the year 1-5% and 45-65%.
- 1-4% and 35-55% is the norm for babies 4-6 years old.
- At the age of 6-12 years, the indicators are 1-4% stab, 40-60% segmented.
For diagnosis, indicators in the analysis are important, not only the independent norm of neutrophils. The ratio between all segmented, young cells must be taken into account, which may indicate the presence of any neutrophilic shift. To determine the presence of a particular disease, a separate number of stab and segmented cells is not essential.
The norm of neutrophils in the blood of women
Certain fluctuations in the parameters of the normal number of immune cells are observed only in the first years of a person's life. In adulthood, this value is always kept at the same level. If immune cells are lowered or increased, then this indicates the development of the disease. The norm of neutrophils in the blood of women should be as follows: 40-60% of segmented cells and 1-4% of stab cells.
The norm of neutrophils in the blood in men
The sex of a person does not matter in determining the normal index of protective cells. The main parameter is age, for example, in a child up to a year there are tangible jumps in the content of leukocytes. The norm of neutrophils in the blood in men is the same as in women: 1-4% rod- and 40-60% segmented cells. A change in this indicator will be associated with inflammatory or infectious processes that have arisen in the body.
Neutrophils below normal - what does it mean
The analysis can reveal low neutrophils in a person if a viral infection has entered the body, an inflammatory disease occurs, radiation exposure was carried out, which caused anemia. A decrease in neutrophils in the blood will be detected if a person lives in poor environmental conditions, uses certain groups of medicines, for example, sulfanilamide, chloramphenicol, penicillin, analgin. This phenomenon is called neutropenia. Depending on the nature of the processes, several variants of this pathology are distinguished. Types of neutropenia:
- congenital;
- acquired;
- idiopathic (unexplained).
Allocate still true and relative neutropenia. In the first case, the number of cells is reduced in the blood, and in the second, they are reduced in relation to other types. Doctors use several categories that indicate the severity of the disease:
- mild neutropenia;
- moderate neutropenia;
- severe neutropenia;
A decrease in the number of immune cells occurs due to their too rapid destruction, long-term inflammatory diseases, functional / organic failures of hematopoiesis in the bone marrow. The issue of treatment, if these cells are lowered, is dealt with by a hematologist. He will determine the root cause of this condition and prescribe a therapy that will eliminate it.
Decreased neutrophils in the blood of a child
This is one of the most important indicators of clinical analysis. Low neutrophils in the blood are detected if the child has recently had a bacterial, viral disease, drank a course of medications, or had food poisoning. If neutrophils in the blood of a child are lowered for no apparent reason, then the doctor may suspect bone marrow pathology. There is a decrease due to its insufficient functioning or resistance to severe diseases. Reduced leukocytes can also be for reasons such as:
- chemical poisoning;
- hereditary disease;
- exposure;
- one of the forms of anemia;
- liver pathology (hepatitis);
- measles;
- rubella.
Neutrophils are lowered in an adult - causes
The reason that in adults the number of protective cells of the body is reduced, as in a child, is often the ongoing strong inflammatory processes. As a rule, a noticeable change occurs only in a severe form of pathology, which takes a large number of leukocytes to fight. If neutrophils are lowered in an adult, the reasons may be the following:
- taking medications that depress the immune system;
- radiation exposure;
- polluted ecology;
- infections;
- body poisoning.
In some people, a condition is detected when protective cells are first lowered, then rise and then decrease again. This phenomenon is called cyclic neutropenia. With such a disease, every few weeks / months, the abs analysis suddenly shows that there are no neutrophils. At the same time, an increased level of eosinophils and monocytes is observed.
Low neutrophils and high lymphocytes
The analysis can reveal that neutrophils are lowered in the blood, lymphocytes are increased. This condition suggests that the patient has had the flu, or an acute viral infection. The number of protective cells should return to the previous values relatively quickly. If this does not happen, then the cause of high lymphocytes can be such pathologies:
- tuberculosis;
- lymphosarcoma;
- lymphocytic leukemia;
Decreased segmented neutrophils in the blood
This condition indicates problems with hematopoiesis from the bone marrow, weakening of the immune defense. A decrease in segmented neutrophils in the blood occurs in the presence of an acute viral infection or exposure to a person of one of the following factors:
- the presence of antibodies to leukocytes;
- immune complexes that circulate in the blood;
- toxic poisoning of the body.
Stab neutrophils are lowered
You can suspect neutropenia if a person is often exposed to infectious diseases. Stab neutrophils will be lowered if a person is often diagnosed with stomatitis, damage to the outer, middle ear, oral cavity, and gums. This group of cells is not fully matured neutrophils. Their number directly affects the overall immunity of a person. There are the following reasons for the decrease in stab cells:
- anemia;
- drug addict;
- poor environmental conditions;
- radiation exposure;
- viral infection;
- neutrophilia;
- some medicines;
- inflammatory processes;
- erythremia;
- exogenous intoxication with lead, poisons;
- chronic myeloid leukemia;
- endogenous intoxications;
- purulent-necrotic angina
- ginguinitis;
- allergy;
- soft tissue necrosis.
Neutrophils are low, monocytes are high
Any pathology that the human body is exposed to causes an increase in the number of monocytes. This phenomenon is called monocytosis. As a rule, it leads to a decrease in leukocytes, which is typical for lymphocytopenia, neutropenia. Neutrophils will be lowered, monocytes will be increased in the presence of the following diseases:
- chronic myelomonocytic or monocytic leukemia;
- arthritis, lupus erythematosus, ploiarteritis;
- prototic / rickettsial viral infection, infective endocarditis;
- acute monoblastic leukemia, lymphogranulomatosis;
- ulcerative colitis, brucellosis, syphilis, enteritis.
How to increase neutrophils in the blood
When a person has a low percentage of neutrophils, it is necessary to eliminate the problem that caused this condition. If this happened due to an infectious disease, then they are independently restored in a short period of time. Under other circumstances, the only way to increase neutrophils in the blood of a child or adult is to eliminate the root cause of their decrease. The doctor may prescribe drug therapy, which is relevant for pronounced neutropenia. If the disease manifests itself moderately, then:
- prescribe leukopoiesis stimulants;
- the use of Pentoxyl, Methyluracil is considered effective.
Therapy should be carried out after consultation with an immunologist under the control of an immunogram. When the body does not respond to treatment and leukocytes are still low, colony-stimulating factor drugs are prescribed, for example, Lenograsti, Filgrastim. The same medicines are immediately prescribed to patients with agranulocytosis. Such drugs are prescribed only under the condition of inpatient treatment, because this is a potent group of drugs.
Video: WBC blood test
Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.
Did you find an error in the text? Select it, press Ctrl + Enter and we'll fix it!The composition of human blood changes from the influence of external causes or changes in the functioning of organs or body systems. A clinical blood test is an informative way to diagnose a large number of diseases.
Blood is a unique biological fluid. One of the main functions - protective, which implies protection from harmful agents of various nature, is performed by white blood cells. These are blood cells - leukocytes that prevent the penetration and spread of infection in the human body. There are several types of them in the body, one of them is neutrophils. To find out how many such cells a person has, the results of laboratory tests allow.
What does the absolute and relative number of neutrophils mean?
The absolute number of neutrophils is the number, or number, of cells of this type found in human blood. They are counted using special equipment in the clinical laboratories of medical institutions when preparing data for a detailed blood test prescribed by a doctor. Neutrophils recorded on the form using an absolute number make it possible to more accurately correlate their number to the norm, which allows physicians to assess the patient's health status with high reliability during diagnostic procedures and make a diagnosis.
Neutrophils can be written as a relative value. The value of this number is a percentage. The result of the analysis indicates the percentage ratio between leukocytes of different types. Their total value is 100%.
If the relative result in such a calculation is in doubt, their absolute value in the blood is calculated using a special formula.
You can determine the number of neutrophils after a blood test
Formula used for calculation
Calculate the number of neutrophils help universal calculators, traditional mathematical methods. The norms of the content of leukocytes, indicators for neutrophils in absolute terms in the blood are calculated according to the formula. The analysis form indicates the indicator of all types of leukocytes, recorded in absolute values. Next, the laboratory assistant paints the percentage of basophils, neutrophils, eosinophils, monocytes and lymphocytes identified by clinical studies.
To calculate neutrophils (stab and segmented) in absolute numbers, you need to enter the total number in proportion, then use mathematical rules, using the formula, to calculate. For example: in the blood of leukocytes, 8.1 G / l was detected, this figure is the sum of all subtypes of cells, that is, 100%. Neutrophil percentage - 22%.
We get the elementary proportion:
- X \u003d (8.1 * 22): 100;
- X \u003d 1.78 G / l.
It is accepted that the absolute value of leukocytes is measured in the form - the number of cells per milliliter of blood. Therefore, the value of X must be multiplied by 1000, we calculate the value, then, by applying rounding, we get the result - 1800 cells / μl. The formula allows you to calculate the level of neutrophils. Identifies deviations from the norm and allows doctors to navigate in the choice of appropriate treatment.
Modern laboratory equipment allows obtaining reliable clinical blood tests. For example: the finished result, which is printed out by an automatic analyzer, contains indicators of neutrophils in the blood in both relative and absolute values. This is convenient, the doctor sees and compares the indicators, he should not waste time on additional calculations. The machine gives out exact numbers that are protected from getting a distorted result calculated by an inattentive specialist.
Special computer programs have been created for doctors to calculate indicators. They are based on the considered formula. As a result of processing the entered indicators, you can find out the necessary parameters, get recommendations for prescribing and adjusting treatment, taking into account the individual characteristics of the patient, which significantly affects the quality of the doctor's work.
Using the program makes it possible to track the dynamics of clinical blood tests for each patient.
segmented neutrophils The norm and deviations from it by the number of neutrophils
The calculation of the number of neutrophils, its result allows us to draw conclusions about the patient's state of health. The neutrophilic norm differs in young children and adults.
A child from birth to 1 year has special indicators of neutrophils. Their condition and dynamics are monitored by doctors. Normally, in a child of this age, the lower redistribution of the indicator of the number of these blood cells is 1000 cells / μl. Children of the first year of life are vulnerable to many infections, since immunity is imperfect, it is in the formation stage. Neutropenia or a decrease in the level of neutrophils can be suspected in infants by many signs: the presence of diseases of the throat, lungs, the appearance of inflammation or infectious lesions of the oral cavity.
The norm for children over 12 years old in terms of the content of blood neutrophils is the same as for adults. Their level can be different, fluctuating in a wide range - 1500 to 7000 cells / μl.
A decrease in indicators less than the value of the lower limit is temporary. A common reason is the preparation of the body to fight viral infections, taking antiviral drugs. Inflammatory and infectious diseases of the throat, gums, dermatological diseases against the background of a decrease in the absolute norm of neutrophils are dangerous. They can lead to serious blood disorders.
A persistent decrease in the level of neutrophils is associated with a long-term decrease in immunity.
If the absolute indicator of the number of neutrophils in a person is exceeded, the symptom may be the result of the development of infections with the formation of purulent-inflammatory processes. Such results are observed with sepsis, severe burns, stroke, myocardial infarction, alcohol poisoning.
Decreased neutrophil levels due to colds How to avoid neutrophil fluctuations in the body?
Medicines can only be prescribed by a doctor. But the patient can follow the rules to normalize and maintain a normal ratio of neutrophils to other leukocytes:
- vaccination against infectious diseases (national vaccination schedule), influenza (annually);
- compliance with hygiene rules, the use of personal protective equipment (masks, oxolin ointment);
- a ban on visiting public places with large crowds of people during a period of rising numbers of respiratory diseases and influenza;
- eating food (meat, eggs, fish, milk) that has undergone sufficient heat treatment.
Proper nutrition will help normalize the level of neutrophils and avoid many other pathologies. Each case of a change in the norm of neutrophils requires special attention of the doctor, additional diagnostic procedures. Self-treatment aimed at increasing or decreasing the level of leukocytes is unacceptable, it can cause irreversible consequences. Many require treatment and systematic monitoring by a hematologist, regular monitoring of the results of laboratory blood tests.
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Leukocyte blood formula
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Neutropenia
What is neutropenia? What are the causes of its occurrence, what threatens the disease and how is it treated?
Neutropenia is a condition in which the number of neutrophils in the blood decreases. Neutrophils are a type of white blood cell, also known as polymorphonuclear leukocytes.
Neutropenia affects the body's ability to fight infections. “The consequences of neutropenia can be various purulent-inflammatory processes of various localizations, increased susceptibility to various infections, viruses, etc. That is, infections, inflammations that can develop when the body’s immune defenses are weakened,” says hematologist Valery Voznyuk.
There are five main types of white blood cells:
- basophils
- eosinophils
- lymphocytes (T cells and B cells)
- monocytes
- neutrophils.
Some white blood cells, called granulocytes, are filled with microscopic granules containing enzymes. Neutrophils, eosinophils and basophils belong to granulocytes and are part of the immune system with non-specific, broad activity. They do not respond exclusively to specific antigens like lymphocytes (B-cells and T-cells). Neutrophils contain enzymes that help cells kill and digest microorganisms and are involved in the process of phagocytosis.
Mature neutrophils have segmented nuclei, while immature neutrophils have a less segmented nucleus. Neutrophils are produced in the bone marrow and then released into the blood. Neutrophils live for about three days.
How is neutropenia defined?
The normal white blood cell range varies slightly from laboratory to laboratory, but generally the range is 4300 - 10800 cells per microliter or cubic millimeter, in international units, 4.3 x 109 - 10.8 x 109 cells per liter.
The absolute neutrophil count (ANC) is determined by the product of the white blood cell count (WBC) and the proportion of neutrophils among white blood cells. For example, if the white blood cell count is 10,000 per µl and 70% neutrophils, the ANC would be 7,000 per µl.
An ANC of less than 1500/µL is the accepted definition of neutropenia. Neutropenia is also subdivided into:
- light 1000-1500/µl
- moderate500-1000/µl
- heavy below 500/µl
What causes neutropenia?
Neutropenia can result from decreased production of neutrophils, destruction of neutrophils, or association of neutrophils.
A number of medical conditions can provoke neutropenia:
Diagnosis of neutropenia
Neutropenia is diagnosed by counting blood cells (CBC). Other tests may be needed to determine the specific cause of neutropenia. Sometimes this is a bone marrow biopsy.
Treatment of neutropenia
Treatment for neutropenia is based on the severity of the disease and the presence of associated infections or symptoms, as well as the general health of the patient. It is obvious that treatment must be directed at any underlying disease process. Treatments directly related to neutropenia may include:
- antibiotics and/or antifungal medicines;
- in case of a severe form, the patient is placed in a sterile room, regularly irradiated with ultraviolet light;
- therapy with corticosteroids or immunoglobulin (intravenous) is used in case of autoimmune diseases;
- vitamin therapy, as an auxiliary.
Neutropenia at a Glance
- Neutropenia is a condition in which the number of neutrophils (a type of white blood cell) in the blood decreases. Neutropenia affects the body's ability to fight infections.
- Neutropenia is defined as an absolute neutrophil count (ANC) less than 1500/µl (1500/microL)
- Neutropenia can be caused by or associated with numerous diseases.
- Most infections that result from neutropenia are associated with bacteria that are normally present on the skin, in the gastrointestinal tract, or in the urinary tract.
Treatment depends on the cause and severity, as well as the underlying cause of the low white blood cell count.
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Leukocyte blood formula
Leukocyte formula - the percentage of different types of leukocytes in a blood smear. During the neonatal period, the ratio of cells differs sharply from that in adults [Nikushkin E.V., Kryuchkova M.I., 1998]. When evaluating the leukocyte formula, it may be necessary to take into account the absolute content of certain types of leukocytes.
Changes in the leukocyte formula accompany many diseases and are often nonspecific. Nevertheless, the diagnostic value of this study is great, as it gives an idea of the severity of the patient's condition, the effectiveness of the treatment. In hemoblastoses, the study of the leukocyte formula often makes it possible to establish a clinical diagnosis.
| Myelocytes | − | 0,5 | 0,5 | − | − |
| Metamyelocytes | − | 4 | 4 | 2,5 | 1,5 |
| Neutrophils are stab | 1−5 | 27 | 26 | 7 | 3 |
| Neutrophils are segmented | 40−70 | 34 | 34 | 39 | 25 |
| Lymphocytes | 20−45 | 22,5 | 24 | 36,5 | 55 |
| Monocytes | 3−8 | 8 | 9,5 | 11 | 11,5 |
| Eosinophils | 1−5 | 3 | 2 | 3,5 | 3 |
| Basophils | 0−1 | 0,75 | 0,25 | − | 0,5 |
| Plasma cells | − | 0,25 | 0,25 | 0,5 | 0,5 |
|
|
|
In many severe infections, septic and purulent processes, the leukocyte formula changes due to an increase in the number of stab neutrophils, metamyelocytes and myelocytes. Such a change in the leukogram with an increase in the percentage of young forms of neutrophils is called a shift to the left; the increase is mainly due to segmented and polysegmented forms - a shift to the right. The severity of the shift of neutrophil nuclei is estimated by the shift index (IS). IS = M + MM + P / C, where M - myelocytes, MM - metamyelocytes, P - stab neutrophils, C - segmented neutrophils. The reference value of the IP is 0.06. The SI value is an important criterion that determines the severity of an acute infection and the overall prognosis.
When analyzing the results of a WBC count in a blood smear, it should always be remembered that this method is not very accurate and can be a source of errors that cannot be completely eliminated (including errors in blood sampling, smear preparation and staining, human subjectivity in interpreting cells). Some types of cells, especially monocytes, eosinophils and basophils, are distributed in a completely irregular smear. A high content of these cells, especially in a limited area of a smear, must be double-checked before a result is issued. When the number of leukocytes in the blood is more than 35×109/l, it is recommended to count at least 200 cells for greater accuracy. The number of studied leukocytes should increase in proportion to the increase in leukocytosis in order to assess a large swab area. If the number of leukocytes in the blood is less than 2×109/l, then some laboratories count less than 100 cells. However, this sharply reduces the accuracy, so this calculation is not recommended. If it is not possible to find 100 cells in a smear, it is proposed to make a leukoconcentrate, however, it should be remembered that during the preparation of the latter, morphological changes in leukocytes and an uneven distribution of cell types occur. If less than 100 or more than 100 cells were counted, this should be reported on the result sheet. Confirmation that the method of calculating the leukocyte formula in a blood smear is not very accurate is given in the table below. data of 95% confidence interval when calculating the leuco formula, obtained on the basis of statistical analysis.
| 0−4 | 0−2 | 0−1 | 0−1 |
| 0−6 | 0−4 | 0−3 | 0−2 |
| 0−8 | 0−6 | 0−4 | 1−4 |
| 0−9 | 1−7 | 1−5 | 2−5 |
| 1−10 | 1−8 | 2−7 | 2−6 |
| 1−12 | 2−10 | 3−8 | 3−7 |
| 2−13 | 3−11 | 4−9 | 4−8 |
| 2−14 | 3−12 | 4−10 | 5−9 |
| 3−16 | 4−13 | 5−11 | 6−10 |
| 4−17 | 5−14 | 6−12 | 7−11 |
| 4−18 | 6−16 | 7−13 | 8−13 |
| 8−24 | 10−21 | 11−19 | 12−18 |
| 12−30 | 14−27 | 16−24 | 17−23 |
| 16−35 | 19−32 | 21−30 | 22−28 |
| 21−40 | 23−37 | 26−35 | 27−33 |
| 25−46 | 28−43 | 30−40 | 32−39 |
| 30−51 | 33−48 | 35−45 | 36−44 |
| 35−56 | 38−53 | 40−50 | 41−49 |
| 39−61 | 42−58 | 45−55 | 46−54 |
The leukocyte index of intoxication (LII) has become widely used to assess the severity of endogenous intoxication, the reference value for which is approximately 1.0. The calculation formula is as follows.
LII = / [(lymphocytes + monocytes) × (eosinophils + 1)] LII fluctuations in patients with infectious and septic diseases objectively correspond to changes in the clinical picture and the severity of endogenous intoxication. An increase in LII to 4–9 indicates a significant bacterial component of endogenous intoxication, a moderate increase (up to 2–3) indicates either a limitation of the infectious process or a focus of necrobiotic tissue changes. Leukopenia with high LII is an alarming prognostic sign. LII can be used to assess the effectiveness of the treatment.
Neutrophilic granulocytes are characterized by the presence of two types of granules in the cytoplasm: azurophilic and specific, the contents of which allow these cells to perform their functions. Azurophilic granules that appear at the myeloblast stage contain myeloperoxidase, neutral and acidic hydrolases, cationic proteins, and lysozyme. Specific granules appearing at the myelocyte stage contain lysozyme, lactoferrin, collagenase, aminopeptidase. Approximately 60% of the total number of granulocytes is located in the bone marrow, making up the bone marrow reserve, 40% - in other tissues, and only less than 1% - in the peripheral blood. Normally, segmented neutrophils and a relatively small number of stab neutrophils (1–5%) are present in the blood. The main function of neutrophils is to protect the body from infections, which is carried out mainly by phagocytosis. The duration of the circulation half-life of neutrophilic granulocytes in the blood is 6.5 hours, then they migrate into the tissues. The lifetime of granulocytes in tissues depends on many factors and can vary from several minutes to several days.
For leukocytosis (leukopenia), a proportional increase (decrease) in the number of leukocytes of all types is uncharacteristic; in most cases, an increase (decrease) in the number of any one cell type is detected, therefore, the terms “neutrophilia”, “neutropenia”, “lymphocytosis”, “lymphopenia”, “eosinophilia”, “eosinopenia”, etc. are used.
Neutrophilosis (neutrophilia) - an increase in the content of neutrophils above 8 × 109 / l. Sometimes the leukocyte reaction is expressed very sharply and is accompanied by the appearance in the blood of young elements of hematopoiesis up to myeloblasts. In such cases, it is customary to speak of a leukemoid reaction. Leukemoid reactions - changes in the blood of a reactive nature, resembling leukemia in terms of the degree of increase in the content of leukocytes (above 50 × 109 / l) or in cell morphology. High neutrophilic leukocytosis (up to 50 × 109 / l) with a rejuvenation of the composition of leukocytes (left shift of varying degrees up to promyelocytes and myeloblasts) can occur with acute bacterial pneumonia (especially croupous) and other severe infections, acute hemolysis. Leukemoid reactions of the neutrophilic type (with or without leukocytosis) are possible in malignant tumors (cancer of the parenchyma of the kidney, breast and prostate glands), especially with multiple bone marrow metastases. Differential diagnosis with blood diseases is carried out on the basis of data from a biopsy of the red bone marrow, a study of alkaline phosphatase in leukocytes (with leukemoid reactions it is high, with chronic myeloid leukemia it is low), and hemogram dynamics.
Neutrophilia is one of the main objective diagnostic criteria for any suppurative process, especially sepsis. It has been established that the higher the leukocytosis, the more pronounced the body's positive reaction to the infection. The number of leukocytes in the peripheral blood, especially in staphylococcal sepsis, can reach 60−70×109/l. Sometimes the dynamics of the leukocyte reaction has a wave-like character. Sepsis caused by gram-negative flora usually occurs with a less pronounced leukocyte reaction. In gram-negative sepsis, an increase in leukocytes up to 18×109/l significantly worsens the prognosis of the disease. Along with an increase in the number of leukocytes in sepsis, their decrease to 3–4 × 109/l is also possible, which is more often observed in gram-negative sepsis. The most significant inhibition of the leukocyte reaction is observed in septic shock (2×109/l). For severe forms of Pseudomonas aeruginosa with the development of septic shock, the development of severe leukopenia, reaching up to 1.6 × 109 / l, is characteristic. In patients with renal insufficiency, neutropenia up to agranulocytosis is also quite often observed.
Neutropenia - the content of neutrophils in the blood is below 1.5 × 109 / l. However, when analyzing the causes of neutropenia, it is necessary to remember about rare diseases accompanied by a decrease in the number of neutrophils in the blood, some of which are presented below.
- Kostmann's neutropenia is an autosomal recessive hereditary disease caused by a defect in the colony-stimulating factor receptor. It is characterized by severe neutropenia (either there are no neutrophils at all, or their content does not exceed 1-2%) and is accompanied by various infections, initially with pustules on the body - boils and carbuncles, later - repeated pneumonia, lung abscesses. Symptoms of the disease appear on the 1-3rd week after birth, if the children do not die on the 1st year of life, then in the future the severity of infectious processes decreases somewhat, and the relative compensation of the disease occurs. The total number of leukocytes in the blood is usually within the normal range (due to an increase in the number of monocytes and eosinophils), neutropenia is very deep, the content of neutrophils is less than 0.5 × 109 / l.
- Benign hereditary neutropenia is a familial disease that often does not manifest itself clinically. In most patients, the total number of leukocytes is normal, neutropenia is moderate (up to 20-30%), other blood parameters are normal.
- Cyclic neutropenia is a disease characterized by periodic (usually at a fairly accurate interval - from 2-3 weeks to 2-3 months, each patient has an individual) disappearance of neutrophils from the blood. Before the onset of an "attack", the patient's blood has a normal composition, and with the disappearance of neutrophils, the content of monocytes and eosinophils increases.
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Agranulocytosis is a sharp decrease in the number of granulocytes in the peripheral blood up to their complete disappearance, leading to a decrease in the body's resistance to infections and the development of bacterial complications. Depending on the mechanism of occurrence, myelotoxic and immune agranulocytosis are distinguished. Myelotoxic agranulocytosis occurs as a result of the action of cytostatic factors. It is characterized by a combination of leukopenia with thrombocytopenia and often with anemia (that is, pancytopenia). Immune agranulocytosis is mainly of two types: hapten and autoimmune, as well as isoimmune.
Eosinopenia - a decrease in the content of eosinophils (less than 0.05 × 109 / l) - in most cases is due to an increase in adrenocorticoid activity, which leads to retention of eosinophils in the bone marrow. Eosinopenia is especially characteristic of the initial phase of the infectious-toxic process. A decrease in the number of eosinophils in the postoperative period indicates a serious condition of the patient.
Basophils are blood cells containing coarse lilac-blue granules in their cytoplasm. The main component of basophil granules is histamine. The life span of basophils is 8−12 days; the period of circulation in the peripheral blood, as in all granulocytes, is short - a few hours. The main function of basophils is to participate in immediate-type hypersensitivity reactions. They are also involved in delayed-type hypersensitivity reactions, in inflammatory and allergic reactions, and in the regulation of vascular wall permeability.
Basophilia - an increase in the number of basophils in the blood (more than 0.2 × 109 / l).
Diseases and conditions that can cause basophilia include:
- allergic reactions (to food, drugs, the introduction of a foreign protein);
- chronic myeloid leukemia, myelofibrosis, erythremia;
- lymphogranulomatosis;
- chronic ulcerative colitis;
- hypofunction of the thyroid gland;
- estrogen treatment.
Lymphocytes, the main cellular element of the immune system, are formed in the bone marrow and actively function in the lymphoid tissue. The main function of lymphocytes is to recognize foreign Ag and participate in the body's immunological response. In children under 4-6 years old, lymphocytes predominate in the total number of leukocytes, that is, they are characterized by absolute lymphocytosis, after 6 years there is a "cross" and neutrophils predominate in the total number of leukocytes.
Lymphocytes are actively involved in the pathogenesis of immunodeficiency states, infectious, allergic, lymphoproliferative, oncological diseases, transplant conflicts, and autoimmune processes. With these processes, the number of lymphocytes in the blood can vary significantly. As a result of an adequate response to antigenic stimulation, an increase in the number of lymphocytes occurs - lymphocytosis, with an inadequate response, the number of lymphocytes may decrease - lymphopenia.
Absolute lymphocytosis: The absolute lymphocyte count in the blood exceeds 4x109/l in adults, 9x109/l in young children and 8x109/l in older children. In clinical practice, leukemoid reactions of the lymphatic type are observed when the blood picture resembles that in acute or chronic leukemia. Leukemoid reactions of the lymphatic type most often develop with infectious mononucleosis, but sometimes also possible with tuberculosis, syphilis, brucellosis. The blood picture in acute infectious mononucleosis is characterized by high leukocytosis due to lymphocytes. Lymphocytes in infectious mononucleosis acquire morphological diversity. A large number of atypical lymphocytes appear in the blood, characterized by nuclear dysplasia and an increase in the cytoplasm and resembling monocytes.
Absolute lymphopenia - the number of lymphocytes in the blood is less than 1 × 109 / l - occurs with some acute infections and diseases. Lymphopenia is characteristic of the initial stage of the infectious-toxic process, which is associated with the migration of lymphocytes from the blood into tissues to the foci of inflammation.
Monocytes are formed in the red bone marrow from monoblasts. After leaving the bone marrow, where, unlike granulocytes, they do not form a bone marrow reserve, monocytes circulate in the blood from 36 to 104 hours, and then go into the tissues. 7×106 monocytes leave the blood in tissues in 1 hour. In tissues, monocytes differentiate into organ- and tissue-specific macrophages. The extravascular pool of monocytes is 25 times greater than the circulating pool.
The system of mononuclear phagocytes combines various types of cells involved in the body's defense reactions. Macrophages play an important role in the processes of phagocytosis. They remove dying cells, remnants of destroyed cells, denatured protein, bacteria, and Ag−AT complexes from the body. Macrophages are involved in the regulation of hematopoiesis, immune response, hemostasis, lipid and iron metabolism.
Monocytosis - an increase in the number of monocytes in the blood more than 0.8 × 109 / l - accompanies a number of diseases. In tuberculosis, the occurrence of monocytosis is considered evidence of the active spread of the tuberculosis process. In this case, an important indicator is the ratio of the absolute number of monocytes to lymphocytes, which is normally 0.3−1.0. This ratio is more than 1 in the active phase of the disease and decreases during recovery, which is used to assess the course of tuberculosis.
With infective endocarditis, sluggish sepsis, significant monocytosis is possible, which is often observed in the absence of leukocytosis. Relative or absolute monocytosis is noted in 50% of patients with systemic vasculitis. Short-term monocytosis may develop in patients with acute infections during convalescence.
Monocytopenia - a decrease in the number of monocytes less than 0.09 × 109 / l. A decrease in the number of monocytes in the blood is observed with hematopoietic hypoplasia.
Neutrophils are the most numerous type of leukocytes, which belongs to the subgroup of granulocytes and is responsible for the primary protective functions of the immune system. Their definition is included in a detailed general blood test with the calculation of the leukoformula. Neutrophils are abbreviated in English as NEUT (NEU).
In the diagnosis of many diseases and tracking the dynamics of the pathological process during treatment, the qualitative and quantitative determination of neutrophils plays an important role. Increasing and decreasing their number helps to determine the type of pathogenic microorganisms, the severity and duration of the pathological process, as well as the state of nonspecific immunity. But before analyzing the causes of neutrophilia and neutropenia, as well as a shift in, we will consider the varieties of neutrophils, the rate of their content in the blood in children and adults, as well as the functions they perform.
Development, varieties and structure
In the process of hematopoiesis, the bone marrow stem cell is the precursor for a number of blast cells, one of which is the myeloblast. It is from it that all granulocytes begin their development. Differentiation and development of neutrophils can be expressed in the following scheme: myeloblast ⇒ promyelocyte ⇒ myelocyte ⇒ metamyelocyte ⇒ stab neutrophil ⇒ segmented neutrophil.
Neutrophils, as well as eosinophils and basophils, belong to granulocytic blood cells, since a characteristic feature of these blood cells is the presence of granules (granules) in the cytoplasm. Neutrophil granules contain lysozyme, myeloperoxidase, neutral and acid hydrolases, cationic proteins, lactoferrin, collagenase, aminopeptidase. It is thanks to the contents of the granules that neutrophils perform their functions. Peripheral blood contains only 1% of the total number of neutrophils in the body, 60% of neutrophils are found in the bone marrow, and about 40% of neutrophils are dispersed throughout other organs of the body.
Normally, 2 types of neutrophils are found in the blood of a healthy person:
- stab
- Segmented
stab neutrophil
Not all neutrophilic leukocytes go through the full stage of maturation in the bone marrow - some of the cells enter the bloodstream at the stage of the stab neutrophil and mature directly in the blood. After entering the bloodstream, the “stab” can already participate in the immune response, but compared to its segmented “brother”, it is still not effective enough against foreign microorganisms, because. its maturation process is not over yet.
The norm of stab neutrophils in children and adults is 1-5% of the total number of leukocytes. A percentage increase in stab neutrophils in the blood is called a “leukocyte shift to the left”, which means a rejuvenation of the circulating pool of cells. The reason for this change is a large loss of segmented neutrophils against the background of a bacterial infection or damage to body tissues.
segmented neutrophil
This is a neutrophilic leukocyte that is fully mature and ready for full-fledged immune defense of the body. Normally, it is the segmented neutrophil that is the main acting force among all neutrophilic leukocytes.
In the bloodstream, it is in 2 states: parietal and freely circulating. Their ratio is approximately the same - 1:1. The parietal (marginal) pool of neutrophils is a rapidly mobilized reserve, which returns to free circulation if necessary.
Microscopic features:
- 2-3 times more than a mature erythrocyte
- Low nucleus to cytoplasm (N/C) ratio (more cytoplasm than nucleus)
- The nucleus is mature and divided into 3-5 lobes, connected by thin filaments of chromatin.
- Nucleols are absent
- More cytoplasm with only secondary granules
- Secondary (specific) neutrophilic granules (lilac)
Segmented (mature) neutrophil is normal
The total residence time of the neutrophil in the bloodstream is 6-20 hours, after which it migrates through the capillary wall into the tissues. Moving from the vascular bed to the tissues is a one-way ticket, because the neutrophil does not return back - it either quickly dies in the presence of an inflammatory process or after 3-4 days is destroyed by apoptosis.
The norm of segmented neutrophils in the blood in adults is 47-72%, in children 18-72% (depending on age, see below).
The norm in the blood test
Indicators of the norm of neutrophilic leukocytes differ for children and adults, this difference is especially strong in young children.
The norm in children
Table number 1 - the norm of neutrophils in the blood in children
| Child's age | The norm of neutrophils,% | |
| stab | Segmented | |
| 1 day | 5-12 | 50-70 |
| 5 days | 1-5 | 30-50 |
| 1 month | 1-5 | 20-35 |
| 2 months | 1-5 | 18-33 |
| 3 months | 1-5 | 17-32 |
| 6 months | 1-5 | 15-30 |
| 1 year | 1-5 | 20-35 |
| 2 years | 1-5 | 25-40 |
| 3 years | 1-5 | 30-45 |
| 4 years | 1-5 | 32-50 |
| 5 years | 1-5 | 35-55 |
| 10-12 years old | 1-5 | 40-60 |
| 15-18 years old | 1-5 | 45-65 |
As can be seen from the table, the norm of the percentage of neutrophils in children in the first years of life varies greatly:
- The total percentage of neutrophilic leukocytes at birth is maximum - 65-75%: the norm of segmented neutrophils in the blood is 50-70%, stab - 5-12%
- In the first 2 weeks, the newborn has a sharp decrease in neutrophils.
- At the age of 1-12 months, the number of neutrophils in children is minimal - 20-35%: the percentage of segmented neutrophils decreases to 20-35%, the relative norm of stab neutrophils in the child's blood remains stable - 1-5%.
- By the age of 7, their number increases to 50% and continues to grow gradually until the age of 18.
Relationship between neutrophils and lymphocytes
Change in the percentage of neutrophils and lymphocytes in children
The illustration clearly shows that in childhood there is an inverse relationship between the percentage of neutrophils and lymphocytes:
- At birth, neutrophils are increased, lymphocytes are reduced, but this ratio is of a short-term nature.
- Already on the 5th day, normally, their number becomes equal - approximately 40-45%. These are neutrophils and lymphocytes in the leukocyte formula of the child.
- By the end of the second week, the picture of the leukocyte formula in children changes dramatically: lymphocytes are increased, and neutrophils are lowered. And this is no longer a short-term phenomenon - for 8-9 months, the percentage of neutrophils will be the lowest for the entire period of development of the child.
- From the age of 9 months, a gradual increase begins, and by 4-5 years, the number of lymphocytes and neutrophils is again equalized (40-45%). This is the second crossover in the leukoformula.
- From the age of 5 until adolescence, the percentage of neutrophils will increase until it reaches the adult norm.
The norm in women
Table number 2 - the norm of neutrophils in women (for all ages)
The norm in men
Table number 3 - The norm of neutrophils in men (all ages)
As can be seen from tables No. 2 and No. 3, the norm of neutrophils in the blood for adult women and men is the same and changes slightly throughout life: stab - 1-5%, segmented - 45-70%.
Normal during pregnancy
In women during pregnancy, the number of neutrophils slightly increases - by an average of 3-5% compared with the norm for adults. The longer the gestation period, the greater the percentage of neutrophils - approximately 1.0-1.5% for each trimester of pregnancy.
Functions of neutrophils
Neutrophils in the human body are responsible for primary nonspecific immunity. It is they who are the first to meet the infection and, if possible, digest it or present it to lymphocytes to trigger specific immunity.
The main functions of neutrophils are:
- Phagocytosis of foreign particles
- Phagocytosis of destroyed body tissues
- Phagocytosis of bacteria and fungi
- Informing other cells of the immune system about the presence of an infection
- Presentation on its surface of foreign particles for the production of antibodies by lymphocytes
Neutrophils are the main "fighters" with microbial cells. This ability is achieved due to a number of its qualities:
- Recognition of a foreign cell
- Chemotaxis - movement of neutrophils towards bacteria
- Absorption of a foreign cell
- Attraction - adhesion of bacteria to the surface of a neutrophil
- Ingestion of a microbe to form a phagolysosome
- Digestion of a foreign particle or microorganism due to lysosome enzymes
A segmented neutrophil is capable of phagocytizing up to 20-30 microbes. Phagocytic activity in stab cells is less pronounced - they are able to absorb only 10-15 pathogenic microorganisms.
Any inflammatory process with the formation of pus is the work of neutrophils. Pus is a mass of dead neutrophils and digested microorganisms.
This article is written using specialized medical literature. All material used was analyzed and presented in an easy to understand language with minimal use of medical terms. The purpose of this article was an accessible explanation of the values of the general blood test, the interpretation of its results.
If you have identified a deviation from the norm in the general blood test, and want to know more about the possible causes, then click on the selected blood indicator in the table - this will allow you to go to the selected section.
The article provides detailed information on the norms of cellular elements for each age. Deciphering a blood test in children requires special attention. Normal blood counts in children depend on age - therefore, accurate information about the child's age is necessary to interpret the results of a blood test. You can learn about age norms from the tables below - separate for each indicator of a blood test.
All of us at least once in a lifetime passed a general blood test. And each person faced a misunderstanding of what is written on the form, what do all these numbers mean? How to understand why this or that indicator is increased or decreased? What could increase or decrease, for example, lymphocytes? Let's take everything in order.
General blood test norms
| Analysis indicator | Norm |
| Hemoglobin | Men: 130-170 g/l |
| Women: 120-150 g/l | |
| RBC count | Men: 4.0-5.0 10 12 / l |
| Women: 3.5-4.7 10 12 / l | |
| White blood cell count | Within 4.0-9.0x10 9 / l |
| Hematocrit (the ratio of the volume of plasma and cellular elements of the blood) | Men: 42-50% |
| Women: 38-47% | |
| Average erythrocyte volume | Within 86-98 µm 3 |
| Leukocyte formula | Neutrophils:
Monocytes: 3-11% Eosinophils: 0.5-5% Basophils: 0-1% |
| Platelet count | Within 180-320 10 9 /l |
| Erythrocyte sedimentation rate (ESR) | Men: 3 - 10 mm/h |
| Women: 5 - 15 mm/h |
Hemoglobin
| Hemoglobin (Hb) is a protein containing an iron atom, which is able to attach and carry oxygen. Hemoglobin is found in red blood cells. The amount of hemoglobin is measured in grams/liter (g/l). Determining the amount of hemoglobin is very important, since when its level decreases, the tissues and organs of the whole body experience a lack of oxygen. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Causes of an increase in hemoglobin
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Low hemoglobin - causes
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RBC count
| red blood cells are small red blood cells. These are the most numerous blood cells. Their main function is to carry oxygen and deliver it to organs and tissues. Erythrocytes are presented in the form of biconcave discs. Inside the erythrocyte contains a large amount of hemoglobin - the main volume of the red disk is occupied by it. | ||||||||||||||||||||||||||||||||
| Causes of a decrease in the level of red blood cellsA decrease in the number of red blood cells is called anemia. There are many reasons for the development of this condition, and they are not always associated with the hematopoietic system.
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Causes of an increase in the number of red blood cells
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| What to do if red blood cells are elevated? | ||||||||||||||||||||||||||||||||
Total white blood cell count
| Leukocytes These are the living cells of our body that circulate with the bloodstream. These cells exercise immune control. In the event of an infection, damage to the body by toxic or other foreign bodies or substances, these cells fight against damaging factors. The formation of leukocytes occurs in the red bone marrow and in the lymph nodes. Leukocytes are divided into several types: neutrophils, basophils, eosinophils, monocytes, lymphocytes. Different types of leukocytes differ in appearance and functions performed during the immune response. | |
Causes of an increase in leukocytesPhysiological increase in the level of leukocytes
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Causes of a decrease in leukocytes
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Hematocrit
| Hematocrit- this is the percentage ratio of the volume of the studied blood to the volume occupied by erythrocytes in it. This indicator is calculated as a percentage. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Causes of an increase in hematocrit
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Causes of a decrease in hematocrit
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MCH, MCHC, MCV, color index (CPU)- norm
Color Index (CPU)- this is a classic method for determining the concentration of hemoglobin in red blood cells. At present, it is being gradually replaced by the MSI index in blood tests. These indices reflect the same thing, only they are expressed in different units.
Leukocyte formula
The leukocyte formula is an indicator of the percentage of different types of leukocytes in the blood of their total number of leukocytes in the blood (this indicator is discussed in the previous section of the article). The percentage of different types of leukocytes in infectious, blood diseases, oncological processes will change. Due to this laboratory symptom, the doctor may suspect the cause of health problems.Types of leukocytes, norm
| Neutrophils | Segmented forms 47-72% |
| Band forms 1-6% | |
| Eosinophils | 0,5-5% |
| Basophils | 0-1% |
| Monocytes | 3-11% |
| Lymphocytes | 19-37% |
In order to find out the age norm, click on the name of the leukocyte from the table.
Neutrophils
| Neutrophils there can be two types - mature forms, which are also called segmented immature - stab. Normally, the number of stab neutrophils is minimal (1-3% of the total). With the "mobilization" of the immune system, there is a sharp increase (by several times) in the number of immature forms of neutrophils (stab). | ||||||||||||||||||||||||||||||||||
| An increase in the level of neutrophils in the blood - this condition is called neutrophilia. Causes of an increase in the level of neutrophils
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| Decreased neutrophil levels - a condition called neutropenia Causes of a decrease in the level of neutrophils
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What is the shift of the leukocyte formula to the left and to the right?Shift of the leukocyte formula to the left means that young, "immature" neutrophils appear in the blood, which are normally present only in the bone marrow, but not in the blood. A similar phenomenon is observed in mild and severe infectious and inflammatory processes (for example, with tonsillitis, malaria, appendicitis), as well as in acute blood loss, diphtheria, pneumonia, scarlet fever, typhus, sepsis, intoxication.Shift of the leukocyte formula to the right means that the number of “old” neutrophils (segmentonuclear) increases in the blood, and the number of nuclear segments becomes more than five. Such a picture occurs in healthy people living in areas contaminated with radioactive waste. It is also possible in the presence of B 12 - deficiency anemia, with a lack of folic acid, in people with chronic lung disease, or with obstructive bronchitis. |
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Eosinophils
| Eosinophils- This is one of the types of leukocytes that are involved in cleansing the body of toxic substances, parasites, and is involved in the fight against cancer cells. This type of leukocyte is involved in the formation of humoral immunity (immunity associated with antibodies) | |
Causes of an increase in blood eosinophils
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Causes of a decrease in eosinophils
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Monocytes
| Monocytes- few, but largest in size, immune cells of the body. These leukocytes are involved in the recognition of foreign substances and the training of other leukocytes to recognize them. They can migrate from the blood to the tissues of the body. Outside the bloodstream, monocytes change their shape and transform into macrophages. Macrophages can actively migrate to the focus of inflammation in order to take part in the cleansing of the inflamed tissue from dead cells, leukocytes, and bacteria. Thanks to this work of macrophages, all conditions are created for the restoration of damaged tissues. | |
Causes of an increase in monocytes (monocytosis)
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Causes of a decrease in monocytes (monocytopenia)
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Basophils
Causes of increased blood basophils
- decreased thyroid hormone levels hypothyroidism
- chicken pox
- food and drug allergies
- condition after removal of the spleen
- treatment with hormonal drugs (estrogens, drugs that reduce the activity of the thyroid gland)
Lymphocytes
| Lymphocytes- the second largest fraction of leukocytes. Lymphocytes play a key role in humoral (through antibodies) and cellular (implemented by direct contact of the destroyed cell and lymphocyte) immunity. Different types of lymphocytes circulate in the blood - helpers, suppressors and killers. Each type of leukocyte is involved in the formation of the immune response at a certain stage. | |
Causes of an increase in lymphocytes (lymphocytosis)
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Causes of a decrease in lymphocytes (lymphopenia)
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platelets
Causes of an increase in platelets
(thrombocytosis, platelet count over 320x10 9 cells/l)- splenectomy
- inflammatory processes (exacerbation of rheumatism,