Types

• Determination of percentage distribution of leucocytes in the peripheral blood is known as differential leucocyte count (DLC). Five types of leucocytes are encountered in normal peripheral blood. They are divided into Granulocytes & Agranulocytes. Neutrophils, Eosinophils and Basophils are Granulocytes and Lymphocytes & Monocytes ar...

Description

• Neutrophils: 50-70%
• Eosinophils: 1-4%
• Basophils: 0-1%
• Lymphocyte: 20-40%
• Monocyte: 2-8%
• Infants and children have fewer neutrophils (40-60%) and more lymphocytes (25-56%)

When to get Tested

• WBC differential count is used as a part of Complete blood count when there is s/s of infection and /or inflammation (fever, chills, body aches, pain and headache)
• To diagnose the cause of a high or low WBC count and diagnose the specific cause of an illness

Elevated Level

Neutrophilia

Physiological

• Exercise
• Pregnancy
• Parturition
• Food intake
• Emotional stress
• Exposure to cold

Pathological

• Non-infective inflammations e.g. rheumatic fever
• Non-inflammatory conditions e.g. myocardial infarction, pulmonary embolism
• Acute haemorrhage
• Muscle trauma e.g. following surgery
• Leukemia e.g. chronic myeloid leukemia
• Toxic conditions e.g. uremia, hepatic coma
• Coricosteroid therapy
• Cushing syndrome
• Trauma
• Heart attack

Eosinophilia

Allergic conditions

• Bronchial asthma
• Urticaria
• Food allergy
• Hay fever

Parasitic infestations

• Hookworm
• Filariasis
• Hydatid disease

Skin diseases

• Psoriasis
• Pemphigus

Others

• Collagen diseases
• Periarteritis nodosa
• Hodgkin’s disease
• Addison’s disease
• Certain leukemias
• Drug Reaction
• Inflammatory diseases

Basophilia

• Chronic myeloid leukemia
• Polycythemia

Lymphocytosis

• Chronic infections - TB, Pertussis, syphilis, brucellosis
• Infectious mononucleosis
• Lymphocytic leukemia
• Lymphoma
• Viral infections
• CP
• Toxoplasmosis

Monocytosis

• Protozoan diseases - Malaria, kala azar
• Hodgkin’s disease
• Monocytic or myelomonocytic leukemia
• ACTH therapy
• Chronic Infections
• Collagen vascular diseases

Decreased Level

Neutropenia

Physiological

• Rare, occurs after chronic exposure to severe cold.

Pathological

• Starvation and debility
• Typhoid and paratyphoid
• Aplastic Anemia
• Parasitic infections e.g. malaria, kala azar
• Viral infections e.g.: measles, influenza, viral hepatitis
• Hypersplenism
• Drug induced Neutropenia
• Auto immune disorders
• Myelodysplasia
• Bone marrow damage (Chemotherapy, Radiotherapy)

Eosinopenia

• ACTH therapy
• Cushing’s disease
• Acute pyogenic infections
• Aplastic anemia

 Basilopenia

• Rare as in severe septicaemia or aplastic anemia

 Lymphocytopenia

• Immuno-suppressive therapy
• ACTH therapy
• Hodgkin’s disease
• Bone marrow failure
• Auto immune disorders
• Infections

Monocytopenia (rare)

• Bone marrow failure
• Aplastic anemia
• Septicemia