The white blood cell differential is often used as part of a complete blood count (CBC) as a general health check. It may be used to help diagnose the cause of a high or low white blood cell (WBC) count, as determined with a CBC. It may also be used to help diagnose and/or monitor other diseases and conditions that affect one or more different types of WBCs.
The five types include: neutrophils, lymphocytes, monocytes, eosinophils and basophils. (For more details on these, see the "What is being tested?" section.)
The differential totals the number of each type and determines if the cells are present in normal proportion to one another, if one cell type is increased or decreased, or if immature cells are present. This information is useful in helping to diagnose the specific cause of an illness, such as:
The five types include: neutrophils, lymphocytes, monocytes, eosinophils and basophils. (For more details on these, see the "What is being tested?" section.)
The differential totals the number of each type and determines if the cells are present in normal proportion to one another, if one cell type is increased or decreased, or if immature cells are present. This information is useful in helping to diagnose the specific cause of an illness, such as:
- Infections caused by bacteria, viruses, fungi or parasites
- Inflammation
- Allergies, asthma
- Immune disorders (e.g., autoimmune disorders, immune deficiency)
- Leukemia (e.g., chronic myeloid leukemia, chronic lymphocytic leukemia)
- Myelodysplastic syndrome
- Myeloproliferative neoplasms (e.g., myelofibrosis)
Some diseases trigger a response by the immune system that causes an increase in certain types of WBCs. A differential may give clues to the specific cause of that immune response. For example, it may help determine whether an infection is caused by bacteria or by viruses.
Other conditions affect the production of certain WBCs by the bone marrow or their survival in the circulation, resulting in either an increase or decrease in their number. A differential informs the healthcare provider as to which type of WBC is low or high.
An abnormal differential result may be followed by other tests such as a blood smear, bone marrow biopsy, chromosome analysis, or immunophenotyping (e.g., flow cytometry). These tests can reveal the presence of abnormal and/or immature populations of WBCs.
Other conditions affect the production of certain WBCs by the bone marrow or their survival in the circulation, resulting in either an increase or decrease in their number. A differential informs the healthcare provider as to which type of WBC is low or high.
An abnormal differential result may be followed by other tests such as a blood smear, bone marrow biopsy, chromosome analysis, or immunophenotyping (e.g., flow cytometry). These tests can reveal the presence of abnormal and/or immature populations of WBCs.
When is it ordered?
The differential is often performed as part of the complete blood count (CBC), which may be ordered at the time of a routine health exam.
A differential may be included as part of the CBC when someone has general signs and symptoms of an infection and/or inflammation, such as:
The differential is often performed as part of the complete blood count (CBC), which may be ordered at the time of a routine health exam.
A differential may be included as part of the CBC when someone has general signs and symptoms of an infection and/or inflammation, such as:
- Fever, chills
- Body aches, pain
- Headache
- A variety of other signs and symptoms, depending on the site of suspected infection or inflammation
Testing may be performed when there are signs and symptoms that the healthcare provider thinks may be related to a blood and/or bone marrow disorder, autoimmune disease or other immune disorder.
If a differential is not done at the same time as a CBC, it may be ordered when results from the CBC are not within the reference ranges.
If a differential is not done at the same time as a CBC, it may be ordered when results from the CBC are not within the reference ranges.
What does the test result mean?
The results indicate the number and/or the percentage of each type of white blood cell that is present in a person's sample of blood.
Results of a differential are usually reported as absolute values of the five types of WBCs and/or may be reported as a percent of the total number of WBCs. Absolute values are calculated by multiplying the total number of WBCs by the percentage of each type of white cell. This information can aid in diagnosing illness and monitoring therapy. Neutrophils typically make up the highest number of WBC, followed by lymphocytes, then monocytes, eosinophils and basophils.
Care must be taken when interpreting the results of a differential. A healthcare provider will consider an individual's signs and symptoms and medical history as well as the degree to which the cells are increased or decreased. A number of factors can cause a transient rise or drop in the number of any one type of cell. A persistent increase or decrease will usually prompt further testing to determine the cause.
Results of a differential are usually reported as absolute values of the five types of WBCs and/or may be reported as a percent of the total number of WBCs. Absolute values are calculated by multiplying the total number of WBCs by the percentage of each type of white cell. This information can aid in diagnosing illness and monitoring therapy. Neutrophils typically make up the highest number of WBC, followed by lymphocytes, then monocytes, eosinophils and basophils.
Care must be taken when interpreting the results of a differential. A healthcare provider will consider an individual's signs and symptoms and medical history as well as the degree to which the cells are increased or decreased. A number of factors can cause a transient rise or drop in the number of any one type of cell. A persistent increase or decrease will usually prompt further testing to determine the cause.
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