Leukocyte shift left or right

To make any accurate diagnosis, any of us goes through a procedure such as giving blood for analysis. In most cases, a finger fence is enough, but sometimes you have to take biomaterial from a vein. Often, doctors in the course of a study use such a definition as a shift in the leukocyte formula. Hearing such an expression somewhere, not everyone will be able to understand what is actually being discussed.

It is worth noting that each person has an individual blood composition, and it can change due to various biological processes. The leukocyte formula just tells about these changes. And it is precisely about her that will be discussed in the topic of this article.

What is a white blood cell count?

There are several types of white blood cells in our blood (more about this in the next section) and each of them performs its own task. The leukocyte formula, or leukogram, is the percentage of all types of blood cells. It also allows you to determine the overall level of white blood cells, thereby identifying a possible shift in the white blood cell count. There is nothing to do with math here. Thanks to this formula, it is possible to assess the general state of human health, as well as identify various probable deviations.

In some cases, you can not only recognize the disease, but also determine the degree of its course with a further outcome. In most cases, an analysis to determine the leukocyte formula is prescribed with general studies during a routine medical examination, with suspected leukemia, as well as a control preventive measure.

White blood cell types

In the blood of the human body, as mentioned above, there is more than one type of white blood cells. These important cells, which fight the infectious threat and respond to tissue damage, form in the bone marrow. There are five types of them:

• lymphocytes;
• neutrophils;
• monocytes;
• basophils;
• eosinophils.

In this case, monocytes, basophils and eosinophils are considered heavy, and lymphocytes and neutrophils are considered light. Each of these varieties of blood cells differs from each other not only in structure, but also performs its function. Analyzing the issue related to the shift of the leukocyte formula, it is worth getting to know them better.

Lymphocytes - these cells belong to the group of agranulocytes and represent the foundation of our immune system. Their main task is to recognize and eliminate foreign antigens, including cancer cells. They also take part in the production of antibodies. In turn, they are divided into three types:

• B cells
• T cells
• NK cells.

Monocytes - are cells belonging to the mononuclear leukocyte group. They are oval in shape and contain a large nucleus, which contains chromatin, a large amount of cytoplasm with many lysosomes. In mature form they have a diameter of 18-20 microns. Monocytes are responsible for the removal of collapsing cells from the body, as well as bacteria and other foreign bodies. In addition to neutralizing microorganisms, they are involved in phagocytosis.

Neutrophils - belong to the granulocyte group and are phagocytes in the classical sense. Largely because of their reason, the leukocyte formula shifts to the right or left. They are divided into stab and segmented. In addition to being mobile, cells are chemotactic and can trap bacteria. But at the same time, neutrophils absorb cells or particles of relatively small size. They take part in the production of certain bactericidal substances, thereby performing a pest control function.

Basophils - also belong to granulocytic leukocytes and has an S-shaped nucleus. In large quantities contain such substances as:

• histamine;
• serotonin;
• leukotriene;
• prostaglandin.

Granules are born in the bone marrow and penetrate into the blood already mature. They are quite large in size, larger than neutrophils and eosinophils. When an inflammatory process occurs, basophils are responsible for transporting white cells to the site of the lesion. They also take an active part in allergic reactions.

Eosinophils - as well as neutrophils are mobile and are involved in phagocytosis. They can absorb foreign bodies, but being microphages they are not able to fight large microorganisms. In addition, eosinophils are characterized by the ability to absorb and bind histamine and some other mediators of allergies and inflammation. If necessary, they can release these substances in the same way as basophils do.

Children's body

At a young age, especially with regard to newborns, there is a more pronounced shift in the leukocyte formula of children. And there is a simple explanation for this - the body of a child or a baby just born is not yet fully formed and various biological processes are actively proceeding in it.

Moreover, unlike adults, the number of white blood cells in the blood, depending on how old the child is, is different. Throughout the entire children's period of life, the child crosses the leukocyte formula twice. The first time this happens after the baby is born. Since the mother's body performed the main protective function for the fetus, the composition of the blood of the newborn is close to the norm in adults.

Coming into the world, the baby immediately begins to get used to the environment, which is reflected in the various processes taking place in his body. By the end of the first month of life, the level of lymphocytes increases significantly.

Being from the age of one to three, the children's body is characterized by an unstable blood composition. That is, from time to time, the leukocyte formula shifts to the left in children or to the right. In this case, the concentration of lymphocytes and neutrophils can vary throughout the day. Also, the cause of such a change may be certain conditions:

• hypothermia;
• long walk in the sun;
• chronic diseases;
• changes at the gene level.

From 4 to 6 years, neutrophils take a leading position. However, in children older than 6-7 years, the blood composition is identical to that of adults. Throughout this period of hormonal changes, a shift of the formula by 10-15% can be observed, which is the norm.

A more visual picture will show the table below.

Thanks to such changes, the immunity of the child’s body is formed, while the child gets acquainted and learns the world around him.

Probable abnormalities in children

Each type of white blood cell is unique in nature due to its individual role in the body. Any deviations that the leukocyte formula undergoes, a shift to the left and right, indicates the presence of any disease.

An increased level of lymphocytes or lymphocytosis is observed in the event of a viral and bacterial infection (pertussis, flu, rubella, measles, tuberculosis). In addition to them, a high concentration of cells is indicated by the presence of bronchial asthma, an autoimmune disease (Crohn or Lyme disease), as well as an innate tendency to allergies. Feeding a child predominantly carbohydrate food in the first year of his life usually leads to an increase in the number of lymphocytes. Their significant drawback (lymphocytopenia) suggests that the bone marrow is susceptible to pathology and can no longer reproduce blood cells in the required amount.

The high neutrophil content also has its own name - Neutrophilia or shift of the leukocyte formula to the left. In some cases, this is due to the body's natural defensive reaction to a threat. For example, an extensive inflammatory process and systemic lupus erythematosus (SLE). If hormonal failure occurs in the body, then neutropenia or a lack of neutrophils occurs. But besides him, extensive intoxication of the body affects this.

A high concentration of monocytes leads to monocytosis, which may appear due to a fungal or viral disease. Here, the clinical picture can already be judged by external signs:

• lymphadenopathy;
• inflammation of the nasopharynx and larynx with neoplasms;
• enlarged liver and characteristic pain in the right hypochondrium.

In addition, an altered leukocyte formula with a shift to the left or right may be associated with a lack of these cells (monocytopenia). This often happens if the body does not get enough B vitamins, folic acid. Often there is iron deficiency anemia.

A large number of basophils are called basophilia. However, this phenomenon is very rare and develops in isolated cases. The cause may be a dangerous pathological change such as tuberculosis, damage to the lymph nodes, myelogenous leukemia, blood oncology.

A high level of eosinophils can indicate a shift in the leukocyte formula, which occurs for one of two possible reasons. The first is that when dairy products are consumed, including lactose, gluten, an allergic reaction is manifested. The second reason is associated with the presence of parasitic worms, which for a long time did not pay attention. It is worth noting that eosinophilia cannot be determined by external signs. But the process can proceed at a rapid pace and give rise to irreversible processes.

Indications for analysis

Indications for blood donation in order to determine the leukocyte formula are the following cases:

• Mandatory examination by a doctor, which should be done annually.
• In the presence of complications after the disease.
• If severe fatigue is observed.

As many experts note, do not underestimate such a blood test. A shift in the leukocyte formula will allow you to diagnose almost any disease of an acute or chronic nature, including oncology.

Only a study will give accurate answers if it is carried out in conjunction with other analyzes. Only in this case, you can make an accurate diagnosis of the disease, as well as its development and outcome.

Analysis procedure

Before undergoing the blood donation procedure in order to determine the leukocyte formula, preparation is needed. It is simple, because all that is required is not to eat food 3-4 hours before the analysis and exclude the use of alcohol. Also, you should not abuse physical and emotional stress. Venous blood is taken for research.

Turning directly to work, the laboratory assistant places the material on a special glass plate, which is located under the microscope. Next, the blood leukocyte formula is determined, a shift to the left or right is detected during the screening of blood cells in the amount of several hundred, so that the total level of all white blood cells can be determined. The next step is to distribute the cells over the entire surface. In this case, the heavy granules are concentrated at the edges, and the light ones are placed in the center.

Often, when calculating white blood cells, two main methods are used:

• Schilling method - a smear is conditionally divided into 4 parts.
• Filipchenko's method - the smear is divided into three parts.

Decoding of the result will be ready after several days of research, and the attending physician is already engaged in its analysis.

Deciphering the results

Decryption of the leukocyte formula should be carried out only by an employee specially trained in this profile. But you can simply compare the results with the norm. Often when a blood cell count is analyzed, the shifts are determined during a manual calculation. But some clinics have gone the modern way and use special equipment for this - an analyzer.

As a rule, he works in automatic mode, but in the case of a sharp deviation from the norm, a specialist enters the work. For comparison, a person will be able to examine 100-200 cells, the apparatus is much larger - several thousand. But, despite the fact that modern equipment allows for a more accurate calculation, errors inevitably occur. Several reasons can influence this: improper blood sampling, a smear and other factors are not prepared.

Shift the formula to the left

The term shift of the leukocyte formula to the left means a high concentration of stab neutrophils, which indicates the occurrence of an inflammatory process. This may still be due to:

• Infectious disease.
• Violations of the acid-base balance.
• Coma.
• Physical overvoltage.

Along with an increase in the concentration of neutrophils, a certain amount of metamyelocytes (not yet mature white blood cells) enter the bloodstream.

In a healthy body, they are only in the red brain. However, due to a strong inflammatory reaction, most healthy neutrophils die quickly. In this case, the bone marrow has to send unripened blood cells to the lesion.

Shift the formula to the right

By definition, a shift in the leukocyte formula to the right is understood as a reduced content of stab neutrophils. But along with this, the number of segmented cells is growing. Often accompanied by a chronic disease of the liver, kidneys, including megablastic anemia. Blood transfusion can also affect this.

The importance of the leukocyte formula is difficult to overestimate, since most of the changes occurring in the body lead to its shift. The concentration of some blood cells increases due to a decrease in the number of others.

Norm indicators

As already known, any deviation from the norm implies the presence of significant changes in the body. Normal lymphocyte counts are 19-37% or 1.2-3x109 units / l; neutrophils (namely segmented) - 47-72% or 2-5.5x109 pcs / l; stab neutrophils - 1-6% or 0.04-0.3 x 109 pcs / l; monocytes - 3-11% or 0.09-0.6 x 109 pcs / l; basophils - 0-1% or 0-0.065x109 pcs./l; and finally, the concentration of eosinophils is 0.5-5% or 0.02-0.3 x 109 pcs / l.

Based on the data obtained from the results of the study, the doctor confirms or rejects the alleged diagnosis. And if the shift of the leukocyte formula has not occurred and everything is within normal limits, then there is no reason for concern.