To make any accurate diagnosis, any of us undergoes such a procedure as donating blood for analysis. In most cases, a finger sample is enough, but sometimes it is necessary to take a biomaterial from a vein. Often, doctors during the study use such a definition as a shift in the leukocyte formula. Having heard such an expression somewhere, not everyone will be able to understand what, in fact, it is about.
It is worth noting that each person has an individual blood composition, and it can change due to various biological processes. The leukocyte formula tells about these changes. And it is about her that we will discuss further in the topic of this article.
What is the leukocyte formula?
There are several types of white blood cells in our blood (more on this in the next section) and each of them performs a different task. The leukocyte formula, or leukogram, is the percentage of all types of blood cells. It also allows you to determine the total level of leukocytes, thereby identifyingpossible shift of the leukocyte formula. There is nothing to do with mathematics here. Thanks to this formula, you can assess the overall he alth of a person, as well as identify various probable deviations.
In some cases, it is possible not only to recognize the disease, but also to 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 suspicion of leukemia, and also as a control preventive measure.
Types of white blood cells
In the blood of the human body, as mentioned above, there is more than one type of leukocytes. These important cells that fight infection and respond to tissue damage are produced 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 types of blood cells differs from each other not only in structure, but also performs its function. When 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 are the foundation of our immune system. Their main task is to recognize and eliminate foreign antigens, including cancer cells. They also take partin 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 have an oval 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 removing decaying cells from the body, as well as bacteria and other foreign bodies. In addition to neutralizing microorganisms, they participate in phagocytosis.
Neutrophils - belong to the granulocytic group and are phagocytes in the classical sense. In many respects, it is precisely for their reason that the leukocyte formula shifts to the right or to the left. They are divided into stab and segmented. In addition to being motile, cells are distinguished by their ability to chemotaxis and can capture bacteria. But at the same time, neutrophils absorb cells or particles of a relatively small size. They take part in the production of some bactericidal substances, thereby performing a pest control function.
Basophiles - also belong to granulocytic leukocytes and have an S-shaped nucleus. In large quantities contain substances such 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 whitecells to the site of the lesion. They also take an active part in allergic reactions.
Eosinophils - as well as neutrophils are mobile and participate in phagocytosis. They can absorb foreign bodies, but being microphages they are not able to fight large microorganisms. In addition, eosinophils are distinguished by their ability to absorb and bind histamine and some other mediators of allergy and inflammation. If necessary, they can release these substances, similar to the way basophils do.
Children's body
At a young age, especially for newborns, there is a more pronounced shift in the leukocyte count of children. And there is a simple explanation for this - the body of a child or a baby that has just been born is not yet fully formed and various biological processes are actively taking place in it.
And unlike adults, the number of leukocytes in the blood, depending on the age of the child, is different. Throughout the entire childhood period of a child's life, the leukocyte formula crosses twice. The first time this happens after the birth of the baby. Since the mother's body performed the main protective function for the fetus, the composition of the newborn's blood is close to the norm in adults.
When born, the baby immediately begins to get used to the environment, which is reflected in the various processes occurring in his body. By the end of the first month of life, the level of lymphocytes increases significantly.
Being between the ages of one and three, the child's bodycharacterized by unstable blood composition. That is, from time to time there is a shift of the leukocyte formula to the left in children or to the right. At the same time, the concentration of lymphocytes and neutrophils can vary throughout the day. Also, certain conditions can serve as the reason for such a change:
- hypothermia;
- long walk in the sun;
- chronic diseases;
- changes at the gene level.
From 4 to 6 years old, neutrophils take the lead. However, in children older than 6-7 years, the composition of the blood is identical to the parameters of adults. During this entire period of hormonal changes, there may be a 10-15% shift in the formula, which is normal.
The table below will show a more clear picture.
| Age | Name of blood cells | Norm, % |
| Newborns | lymphocytes | 20-35 |
| neutrophils | 65 | |
| monocytes | 3-5 | |
| basophils | 0-1 | |
| eosinophils | 1-2 | |
| First month of life | lymphocytes | 65-70 |
| neutrophils | 20-25 | |
| monocytes | 3-6 | |
| basophils | 1-2 | |
| eosinophils | 0, 5-1 | |
| 1 to 3 years old | lymphocytes | 35-55 |
| neutrophils | 32-52 | |
| monocytes | 10-12 | |
| basophils | 0-1 | |
| eosinophils | 1-4 | |
| 4 to 6 years old | lymphocytes | 33-50 |
| neutrophils | 36-52 | |
| monocytes | 10-12 | |
| basophils | 0-1 | |
| eosinophils | 1-4 | |
| Over 6-7 years old | lymphocytes | 19-35 |
| neutrophils | 50-72 | |
| monocytes | 3-11 | |
| basophils | 0-1 | |
| eosinophils | 1-5 |
Thanks to such changes, the immunity of the child's body is formed, while the child gets to know and learns about the world around him.
Probable abnormalities in children
Everyonethe type of leukocyte 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 some kind of disease.
An increased level of lymphocytes or lymphocytosis is observed in the event of a viral and bacterial infection (whooping cough, influenza, rubella, measles, tuberculosis). In addition to them, a high concentration of cells is indicated by the presence of bronchial asthma, an autoimmune disease (Crohn's or Lyme disease), as well as an innate tendency to allergies. Feeding a child a predominantly carbohydrate food in the first year of his life usually leads to an increase in the number of lymphocytes. Their significant deficiency (lymphocytopenia) indicates that the bone marrow is affected by pathology and can no longer reproduce blood cells in the required quantity.
High neutrophil content also has its own name - Neutrophilia or a shift of the leukocyte formula to the left. In some cases, this is due to the body's natural defensive reaction to some kind of threat. For example, an extensive inflammatory process and systemic lupus erythematosus (SLE). If a hormonal failure occurs in the body, then neutropenia or a lack of neutrophils occurs. But besides him, this is affected by extensive intoxication of the body.
High concentration of monocytes leads to monocytosis, which may occur due to a fungal or viral disease. Here, the clinical picture can already be judged byexternal features:
- 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 receive enough B vitamins, folic acid. Iron deficiency anemia often occurs.
A large number of basophils is 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, myeloid leukemia, blood cancer.
A high eosinophil count may indicate a shift in the WBC count, which occurs for one of two possible reasons. The first is that when eating dairy products, including lactose, gluten, an allergic reaction occurs. The second reason is related to the presence of parasitic worms, which have been overlooked for a long time. 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 testing
Indications for blood donation in order to determine the leukocyte formula are the following cases:
- Mandatory medical examination to be done annually.
- If there is a complication after the disease.
- If observedsevere fatigue.
As many experts say, do not underestimate such a blood test. A shift in the leukocyte formula will allow diagnosing almost any disease of an acute or chronic nature, including oncology.
Only a study will give accurate answers if it is carried out in combination with other tests. Only in this case it is possible to make an accurate diagnosis of the disease, as well as its development and outcome.
Analysis procedure
Before you go through the blood donation procedure in order to determine the leukocyte formula, you need preparation. It is simple, because all that is required is not to eat 3-4 hours before the analysis and to exclude the use of alcohol. You also need not to abuse the physical and emotional stress. Venous blood is taken for research.
Going directly to work, the laboratory assistant places the material on a special glass plate, which he places under the microscope. Further, the leukocyte blood count 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 overall level of all leukocytes can be determined. The next step is to distribute the cells over the entire surface. In this case, heavy granules are concentrated at the edges, and light ones are placed in the center.
There are two main ways of counting white blood cells:
- Schilling method - the smear is conditionally divided into 4 parts.
- Filipchenko's method - the smear is divided intothree pieces.
The transcript of the result will be ready after a few days of the study, and the attending physician is already analyzing it.
Transcript of results
Deciphering the leukocyte formula should only be carried out by an employee specially trained in this profile. But you can simply compare the results obtained with the indicators of the norm. Often, when the leukocyte blood count is analyzed, shifts are determined during manual calculation. But some clinics have gone the modern way and use special equipment for this - an analyzer.
As a rule, it works in automatic mode, but in case of a sharp deviation from the norm, a specialist takes over. 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 you to make more accurate calculations, errors inevitably happen. This can be influenced by several reasons: incorrect blood sampling, a smear not prepared well, and other factors.
Shift formula to the left
The term shift of the leukocyte formula to the left refers to a high concentration of stab neutrophils, which indicates the course of the inflammatory process. This may also be due to:
- Infectious disease.
- Acid-base imbalance.
- Coma.
- Physical surge.
Along with an increase in the concentration of neutrophils, a certain amount of metamyelocytes (not yet mature leukocytes) enter the bloodstream.
In a he althy body, they are found only in the red brain. However, due to the strong inflammatory response, most he althy neutrophils quickly die. In this case, the bone marrow has to send unripened blood cells to the lesion.
Shift formula right
Under the definition of the shift of the leukocyte formula to the right is meant a reduced content of stab neutrophils. But along with this, the number of segmented cells is growing. Often accompanied by chronic liver disease, kidney disease, including megablastic anemia. This can also be affected by blood transfusion.
The importance of the leukocyte formula is difficult to overestimate, since most of the changes that occur in the body lead to its shift. The concentration of some blood cells increases at the expense of a decrease in the number of others.
Normal indicators
As already known, any deviation from the norm implies the presence of significant changes in the body. Normal indicators of lymphocytes are 19-37% or 1.2-3x109 pcs/l; neutrophils (specifically segmented) - 47-72% or 2-5, 5x109 pcs / l; stab neutrophils - 1-6% or 0.04-0.3x109 pcs/l; monocytes - 3-11% or 0.09-0.6x109 pcs/l; basophils - 0-1% or 0-0, 065x109 pcs/l; and finally, the concentration of eosinophils is 0.5-5% or 0.02-0.3x109 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 in the leukocyte formula has not occurred and everything is within the normal range, then there is a reason forworry does not exist.
