Shift of the leukocyte formula to the left or right

To put any exact diagnosis, any of us undergoes a procedure such as blood donation for analysis. In most cases, enough fence from the finger, but sometimes you have to take a biomaterial from the vein. Often, doctors in the study use a definition such as a shift in the leukocyte formula. Hearing somewhere such an expression, not everyone will be able to understand what, in fact, is talking about.

It should be noted that in every person the composition of the blood is of an individual character, and it can change as a result of various biological processes. About these changes just tells the leukocyte formula. And it will be discussed further in the topic of this article.

What is the leukocyte formula?

In our blood there are several types of leukocytes (more about this in the next section) and each of them fulfills its task. The leukocyte formula, or leukogram, is the percentage of all types of blood cells. It also allows to determine the overall level of leukocyte count, thereby revealing a possible shift of the leukocyte formula. Nothing to do with mathematics here. Thanks to this formula, you can assess the overall health of a person, as well as identify various likely deviations.

In some cases, you can not only recognize the disease, but also determine the extent of its course with a further outcome. In most cases, an analysis of the definition of the leukocyte formula is prescribed with general studies during a planned medical examination, with suspicion of leukemia, and also as a control prophylactic measure.

Species of leukocytes

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

• Lymphocytes;
• Neutrophils;
• Monocytes;
• Basophils;
• Eosinophils.

In this case, monocytes, basophils and eosinophils are considered to be severe, and lung lymphocytes and neutrophils. Each of these varieties of blood corpuscles differs from each other not only in structure, but also fulfills their function. Analyzing the question related to the shift of the leukocyte formula, it is worth getting acquainted with them more closely.

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 participate in the production of antibodies. In turn, they are divided into three types:

• B-cells;
• T-cells;
• NK cells.

Monocytes are cells belonging to a single-nucleated leukocyte group. They are oval in shape and contain a large-sized nucleus, which contains chromatin, a large amount of cytoplasm with a lot of lysosomes. They have a diameter of 18-20 μm in a mature form. Monocytes are responsible for removing from the body of destructive cells, as well as bacteria and other foreign bodies. In addition to neutralizing microorganisms, they participate in phagocytosis.

Neutrophils - belong to the granulocyte group and are phagocytes in the classical sense. In many respects it is due to their cause that the leukocyte formula shifts to the right or to the left. They are divided into stabloconuclear and segment-nuclear. In addition to being mobile, cells are characterized by their ability to chemotaxis and can capture bacteria. But neutrophils absorb cells or particles of relatively small size. They take part in the production of certain bactericidal substances, thus performing the disinsection function.

Basophils - also belong to granulocyte leukocytes and has a 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 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 participate in phagocytosis. They can absorb foreign bodies, but being microphages can not fight large microorganisms. In addition, eosinophils are characterized by the ability to absorb and bind histamine and some other mediators of allergy and inflammation. If necessary, they can release these substances in the same way that 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 this is a simple explanation - the body of a child or newly born baby 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 how old the child is, is different. Throughout the child's period of life, the child twice crosses the leukocyte formula. The first time this happens after the birth of the baby. Since the mother's body performed the basic protective function for the fetus, the composition of the blood of the newborn is approximated to the norm in adults.

Emerging into the light, 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 at 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. At the same time, the concentration of lymphocytes and neutrophils can vary throughout the day. Also, certain conditions may serve as the reason for such a change:

• Supercooling;
• Long walk in the sun;
• Chronic diseases;
• Changes at the gene level.

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

A more graphic picture will be shown in the table below.

Change in the level of blood cells, depending on the age of the child

Age	Name of blood cells	Norm,%
Newborns	Lymphocytes	20-35
	Neutrophils	65
	Monocytes	3-5
	Basophils	0-1
	Eosinophils	1-2
The first month of life	Lymphocytes	65-70
	Neutrophils	20-25
	Monocytes	3-6
	Basophils	1-2
	Eosinophils	0.5-1
From 1 to 3 years	Lymphocytes	35-55
	Neutrophils	32-52
	Monocytes	10-12
	Basophils	0-1
	Eosinophils	1-4
From 4 to 6 years	Lymphocytes	33-50
	Neutrophils	36-52
	Monocytes	10-12
	Basophils	0-1
	Eosinophils	1-4
Older than 6-7 years	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 organism is formed, while the child acquires and knows the world around him.

Probable deviations from the norm in children

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

Elevated levels of lymphocytes or lymphocytosis occur if there is a viral and bacterial infection (pertussis, flu, rubella, measles, tuberculosis). In addition, the high concentration of cells indicates the presence of bronchial asthma, an autoimmune disease (Crohn's disease or Lyme disease), as well as an innate tendency to allergies. Feeding a child with predominantly carbohydrate food in the first year of his life usually leads to an increase in the number of lymphocytes. Their significant deficiency (lymphocytopenia) suggests that the bone marrow is exposed to pathology and can no longer reproduce blood cells in the required quantity.

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

A high concentration of monocytes leads to monocytosis, which can result from fungal or viral diseases. Here the clinical picture can be judged by external signs:

• Lymphadenopathy;
• Inflammation of the nasopharynx and larynx with neoplasms;
• Enlarged liver and characteristic painful sensations in the right hypochondrium.

In addition, an altered leukocyte formula with a left or right shift may be associated with a deficiency of these cells (monocytopenia). This often happens if the body does not get enough vitamins of group B, 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 can be a dangerous pathological change such as tuberculosis, lesion of lymph nodes, myeloleukemia, blood oncology.

The shift of the leukocyte formula can indicate a high level of eosinophils, which occurs for one of two possible causes. The first is that with the use of dairy products, including lactose, gluten, an allergic reaction appears. The second reason is related to the presence of parasitic worms, which for a long time did not pay attention. It is worth noting that eosinophilia can not be determined by external signs. But the process can proceed at a rapid pace and generate irreversible processes.

Indications for the analysis

Indications for blood donation for the purpose of determining the leukocyte formula are the following:

• Mandatory examination by a doctor, which should be held annually.
• If there is a complication after the disease.
• If there is severe fatigue.

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

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

Analysis procedure

Before you go through the procedure for blood donation to determine the leukocyte formula, you need training. It is simple, because all that is required is not to take food 3-4 hours before the analysis and to exclude the use of alcohol. You also need not to abuse physical and emotional stress. Venous blood is taken for the study.

Going directly to work, the lab technician places the material on a special glass plate, which is placed under a microscope. Further, the leukocyte blood formula is determined, a shift to the left or right is detected during the screening of blood cells in the number of several hundred, so that the overall level of all leukocytes can be determined. The next step is to distribute the cells throughout the surface. In this case, the heavy granules concentrate around the edges, and the lungs are placed in the center.

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

• The Shilling method - a smear conditionally divided into 4 parts.
• Method Filipchenko - a smear is divided into three parts.

The decoding of the result will be ready after several days of research, and its analysis is already being done by the attending physician.

Explanation of results

Decoding of the leukocyte formula should be conducted only by an employee specially trained for this profile. But you can simply compare the results with the rates. Often when the leukocyte blood formula is analyzed, the shifts are determined in the course of manual calculation. But some clinics went the modern way and use for this purpose special equipment - an analyzer.

As a rule, it works in automatic mode, but in case of abrupt deviation from the norm, a specialist enters the work. For comparison, a person will be able to inspect 100-200 cells, the device is much larger - several thousand. But, despite the fact that modern equipment allows for more accurate calculation, errors inevitably occur. This can be influenced by several reasons: wrong blood sampling, not so prepared a smear and other factors.

Shift formula to the left

By the term shift of the leukocyte formula to the left is meant a high concentration of stab neutrophils, which indicates the course of the inflammatory process. This can still happen because of:

• An infectious disease.
• Violations of acid-base balance.
• Comatose state.
• Physical overstrain.

Along with an increase in the concentration of neutrophils, a certain amount of metamyelocytes (not yet matured leukocytes) enter the blood.

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 to the focus of the lesion is not yet ripe blood cells.

Shift formula to the 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 grows. Often accompanied by a chronic disease of the liver, kidneys, including megablastic anemia. This can also be influenced by blood transfusion.

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 is increased by reducing the number of others.

Indicators of the norm

As already known, any deviation from the norm presupposes the presence of significant changes in the body. Normal values of lymphocytes are 19-37% or 1.2-3x109 pcs / l; Neutrophils (namely segment-nuclear) - 47-72% or 2-5,5х109 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 / liter.

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 the norm, then there is no cause for concern.