white blood cell differential count & morphology Test

Leukocyte Differential count & morphology

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what is white blood cell - differential count & morphology?

White blood cells (WBC) are a heterogeneous group of nucleated cells that can be found in circulation for at least a period of their life. They play a most important role in phagocytosis and immunity and therefore in defence against infection. The blood differential test measures the percentage of each type of white blood cell (WBC).

There a five type of white blood cells, each with different functions. These include

  1. Neutrophils,
  2. Lymphocytes,
  3. Monocytes
  4. Basophils,
  5. Eosinophils.

The differential white blood cell count test detects whether these cells are present in normal proportion to one another, whether cell type is increased or decreased or if immature cells are present. This helps in diagnosing the specific type of illness that affects the immune system.

Abnormally high or low counts indicate the presence of many forms of the disease.

what is wbc blood test?

As we know, there are 5 types of WBC’s present in the body and each being in normal proportion to one another is quite essential. If there is any abnormality in the ratio, the information can be useful in diagnosing a range of illnesses.

The differential count and WBC morphology test in order to ascertain the same. One can undergo these tests at a hospital or a diagnostic centre or at home.

understanding the wbc morphology

It is also important to understand WBC morphology in order to diagnose the white blood cell-related disorders.

Any abnormal WBC morphology can be a cause of an underlying infection.

Some of the examples of abnormalities in white blood cell morphology include:

  • Coarse granules present in the cytoplasm of neutrophils are seen in severe bacterial infections.
  • Presence of vacuoles in neutrophils indicate a condition called phagocytosis.
  • The premature leukocytes are another example of an abnormal morphology of the WBC. These are called blast cells and are seen in conditions like leukaemia.

when do you expect results?

24 to 36 Hours

why get tested?

The Differential count test is conducted to diagnose an illness impacting the immune system like infection or viral condition, or any other diseases that impact the white blood cells such as leukaemia.

Reason to take White blood cell (Leukocyte) Differential count & morphology Test

  • Depression
  • Weakness
  • Reduced appetite
  • Dizziness Fatigue
  • Difficulty in breathing
  • Cold
  • hands and feet 
  • General malaise
  • Chest pain
  • Brittle nails, pale skin and gums

Preparations Needed for White blood cell (Leukocyte) Differential count & morphology Test

A WBC count or differential test does not require any special prior preparation. No Fasting Required.No other special preparations required. But the doctor may ask you to stop certain medications that might have an effect on the test results.

sample required?

Specimen type: EDTA (Blood Sample), Specimen collection procedure: Venipuncture - Collection of blood from a vein, usually from the arm.

what other tests might i have along with wbc morphology test?

If there are any abnormal findings in the report, the doctor might prescribe for additional tests depending upon the need.

Some of these tests include

  • Bone marrow biopsy
  • Eosinophil count test
  • Immunophenotyping
  • Flow cytometry
  • Polymerase chain reaction (PCR) test

how is wbc morphology test done?

The procedure to conduct the WBC count and differential is similar to a normal blood test. The sample is collected from the vein on the bend of your arm. This is then sent to a lab for analysis.

does wbc morphology test pose any risk?

Apart from bruising or soreness at the puncture site, there are no significant complications of the test. In rare cases, a condition called hematoma occurs when the blood gets directly accumulated under the skin.

what might affect my test results?

Any prescription or non-prescription medications that you are currently on or have taken before the test may alter test results. Hence it is important that the doctor is informed about any such medications.

what is a white blood cell count?

A WBC count is nothing but the measure of white blood cells in your body. The test is generally inclusive of the complete blood count investigation. These white blood cells are generally known to originate in the bone marrow and travel through the bloodstream.

The number of white blood cells in the body at a time can be helpful in detecting any underlying infection. The normal WBC count for a healthy individual should be between 3,500 and 10,500 white blood cells per microliter of blood (MCL). Any deviation from the white blood cell count normal range should not be ignored.

The normal percentage of types of cells that make WBC's is done asunder. Any deviation from the WBC count normal range could be attributed to an underlying condition.

what are the symptoms of an abnormal wbc count?

The symptoms like body ache, chills, fever, and severe headaches are only visible when there is a low WBC count in the blood. There are no separate symptoms for high WBC count in blood. One might experience symptoms of the underlying problem that causes this increase.

what are the causes of low wbc count?

The low WBC count causes could be due to medical conditions like

  • HIV,
  • Lymphoma,
  • Liver
  • Spleen diseases,
  • Radiation therapy,
  • Damage or disorders in bone marrow
  • Any autoimmune disorders.

Also sometimes certain medications like antibiotics also can cause a decline in the WBC count.

causes and treatment for high blood cell count

One of the high white blood cell count causes could be an underlying medical condition called leukocytosis. It is generally known to be triggered in response to the below conditions.

  • Smoking, emotional stress and excessive exercise.
  • A tumour present in the bone marrow, arthritis, tuberculosis and tissue damage.
  • Immunosuppression, pregnancy and allergic reactions are some of the other causes of leukocytosis.

Apart from medications lifestyle changes are also equally important in high WBC count treatment. A well-balanced diet including fruits and vegetables that have powerful immune boosters is essential. Also, avoid fried and processed food as they tend to weaken your immune system.

A good night’s sleep and exercise make for an important change required to decrease the high WBC count naturally. Daily intake of foods rich in antioxidants like grapes, onions, leeks, garlic, and tea promotes healthy white blood cells in the blood.

Also, foods rich in vitamin c like oranges, berries, lemon etc. also help in boosting the immune system, thereby regulating the production of white blood cells.

Understanding results ofWhite blood cell Differential count & morphology

Reference RangeInterpretation
Female2 – 10%
9.1-17 years20-64%
2.1-9 years20-64%
1-2 years20-64%
Male44 – 76%
Female44 – 76%
2.1 – 9 years30- 74  %
9.1- 17 years44 – 76%
Female40 to 80%
2 years21- 67%
0.1 – 1 year16 – 52%
Male40 to 80%
2.1-9 years0 to 2&
1-2 years0 to 2%
9.1-17 years0 to 2&
Male1 to 6%
Female1 to 6%
1-2 years0 - 3%
1-2 years1.9 - 6.8%
0.1 - 1 year9.1-17 years
9.1-17 years4- 8.9%
2.1-9 years1.9 – 6.8%
Female0 to 2
Male0 to 2
Male2 – 10%
0.1 - 1 year0 to 2%
0.1 - 1 year0 – 5 %
2.1-9 years0 – 6 %
0.1 - 1 year32 - 69%
9.1-17 years0 – 6 %

“*A reference range is a set of values which helps he healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranfes may also vary between labs, in value and units depending on instruments used and method of establishement of reference ranges’’


A WBC count and differential might give a fair idea of an underlying condition. But, in order to confirm a diagnosis, the doctor may ask for more tests to be performed.