Synonym
Tubes
- Lavender top tube
- 5 mL of whole blood
Info
The WBC count and differential are a routine part of the complete blood count (CBC) test.
Eosinophils are granulocytes that dispose of cellular debris; but also seems to be involved in allergic responses. These cells have a potent cytotoxic effect, especially on parasites, by the release of destructive proteins (major basic protein, eosinophil cationic protein and eosinophil derived neurotoxin) into the extracellular space.
- Leukocytes or WBCs are differentiated into 5 different types:
- Basophils
- Eosinophils
- Lymphocytes
- Monocytes
- Neutrophils
Clinical
The eosinophil count is primarily useful in assessing allergic response or parasitic infection. Increased eosinophils, otherwise known as eosinophilia, is more likely to be due to parasitic infection in the pediatric patient and more likely to be due to drug reaction in adults or children on medications.
The White Blood Cell (WBC) count and differential, which the eosinophil count is part of, has clinical utility in:
- Evaluation of infection or inflammation
- Assist in determination of viral versus bacterial infection
- Assist in evaluation of the stage and severity of an infection
- Detect allergic response or parasitic infections (elevated eosinophils)
- Evaluation for hematologic malignancy/disorders
- Detecting and identifying various types of myelopoietic disorders
- Detecting and identifying various types of leukemia
- Evaluating bone marrow depression
- Evaluation of need for further tests, such as manual WBC differential or bone marrow biopsy
- Evaluation of drug effects, response to chemotherapy or radiation
- Evaluation of effect of cytotoxic agents
- Screening test as part of a CBC on admission to a health care facility or before surgery
Additional information:
- The interpretation of a normal, high or low result of any given WBC type requires the context of the patient's clinical condition, history and physical examination
- Specific patterns of leukocyte response are seen in various types of diseases as determined by the differential count
- The life span of leukocytes is normally 13–20 days, after which the cells are destroyed in the lymphatic system and are excreted from the body in fecal matter.
Nl Result
Consult your laboratory for their normal ranges as these may vary somewhat from the ones listed below.
WBC Differential
| Conv. Units
(%) | SI Units
(fraction) |
|---|
| Birth | 0-2 | 0-0.02 |
| 2-8 weeks | 0-3 | 0-0.03 |
| 2-6 months | 0-3 | 0-0.03 |
| 7-12 months | 0-3 | 0-0.03 |
| 1-5 years | 0-3 | 0-0.03 |
| 6-17 years | 0-3 | 0-0.03 |
| Adults | 0-4 | 0-0.04 |
High Result
Conditions, which may cause increased number of eosinophils (eosinophilia), include:
- Allergic diseases:
- Asthma
- Atopic dermatitis
- Dermatitis herpetiformis
- Eczema
- Pemphigus
- Seasonal rhinitis or hay fever
- Collagen vascular diseases:
- Dermatomyositis
- Eosinophilic fasciitis
- Hypersensitivity vasculitis
- Progressive systemic sclerosis
- Systemic lupus erythematosus
- Drugs causing increase in eosinophils include:
- Aldesleukin
- Allopurinol
- Alprazolam
- Aminosalicylic acid
- Amoxapine
- Amoxicillin
- Amphotericin B
- Ampicillin
- Arsenicals
- Auranofin
- Aztreonam
- Benazepril
- Capreomycin
- Captopril
- Carbamazepine
- Carbenicillin
- Carisoprodol
- Caspofungin
- Cefamandole
- Cefdinir
- Cefixime
- Cefonicid
- Cefoperazone
- Cefotaxime
- Cefotetan
- Cefoxitin
- Cefpodoxime
- Ceftazidime
- Ceftizoxime
- Ceftriaxone
- Cephalexin
- Cephalothin
- Chloramphenicol
- Chloropromazine
- Cinoxacin
- Ciprofloxacin
- Clindamycin
- Clofibrate
- Clonazepam
- Cloxacillin
- Cyclobenzaprine
- Cytokines
- Danazol
- Dantrolene
- Dapsone
- Demeclocycline
- Desipramine
- Diazoxide
- Diclofenac
- Digitalis
- Donepezil
- Doxepin
- Doxorubicin
- Doxycycline
- Enalapril
- Ethosuximide
- Famciclovir
- Felbamate
- Flucytosine
- Fluorouracil
- Fluphenazine
- Furazolidone
- Gemfibrozil
- Gentamicin
- Gold
- Granulocyte colony-stimulating factor
- Haloperidol
- Hepatitis a vaccine
- Ibuprofen
- Imipenem/cilastin
- Interleukin
- Iodides
- Isoniazid
- Ketorolac
- Lamotrigine
- Lansoprazole
- Levodopa
- Loracarbef
- Maprotiline
- Mefenamic acid
- Mephenytoin
- Methsuximide
- Methysergide
- Minocycline
- Moxalactam
- Nafarelin
- Nafcillin
- Naproxen
- Netilmicin
- Nitrofurantoin
- Nizatidine
- Norfloxacin
- NSAIDS
- Ofloxacin
- Para-aminosalicylic Acid
- Paroxetine
- Penicillamine
- Penicillins
- Pentazocine
- Pergolide
- Perphenazine
- Phenytoin
- Piperacillin
- Piroxicam
- Procarbazine
- Propafenone
- Quinolones
- Ramipril
- Ranitidine
- Rifampin
- Spironolactone
- Streptomycin
- Sulfonamides
- Sulfasalazine
- Tetracycline
- Thioridazine
- Thiothixene
- Ticarcillin
- Ticlopidine
- Tobramycin
- Topiramate
- Triazolam
- Trifluoperazine
- Trimipramine
- Trovafloxacin
- Valproic acid
- Venlafaxine
- Zalcitabine
- Zolmitriptan
- Fungal infections
- Allergic bronchopulmonary aspergillosis (ABPA)
- Coccidioidomycosis
- Histoplasmosis
- Gastrointestinal disease
- Allergic colitis
- Chronic pancreatitis
- Eosinophilic gastroenteritis
- Inflammatory bowel disease
- Hematologic disorders
- Chronic myelogenous leukemia
- Myelofibrosis
- Myeloid metaplasia
- Pernicious anemia
- Polycythemia Vera
- HIV infection
- Hypereosinophilic syndrome (HES)
- Immunodeficiency
- Hyperimmunoglobulinemia E
- IgA deficiency
- Nezelof syndrome
- Wiskott-Aldrich syndrome
- Malignancies
- Carcinomas; Various
- Hodgkin's disease
- Non-Hodgkin's lymphoma
- Parasitic diseases
- Ascaris lumbricoides
- Dientamoeba fragilis
- Echinococcus
- Eosinophilic pneumonia
- Ascaris lumbricoides
- Strongyloides stercoralis
- Filariasis
- Isospora belli
- Microfilariae
- Schistosomiasis
- Strongyloides stercorlis
- Taenia
- Trichinosis
- Visceral larva migrans
- Pulmonary eosinophilias
- Churg-Strauss syndrome
- Hypersensitivity pneumonitis - allergic bronchopulmonary aspergillosis (ABPA)
- Löeffler's syndrome
- Pulmonary infiltrate with eosinophilia (PIE syndrome)
- Tropical pulmonary eosinophilia (caused by microfilariae)
- Skin disorders
- Acute urticarial reactions
- Atopic dermatitis
- Dermatitis herpetiformis
- Eczema
- Pemphigus
- Others
- Addison's disease
- Eosinophilia-myalgia syndrome
- Idiopathic adrenal insufficiency
- Leprosy
- Sarcoidosis
- Scarlet fever
- Tuberculosis
- Wegener's granulomatosis
Low Result
- Drugs causing decreased eosinophils (eosinopenia), include:
- Amitriptyline
- Aspirin
- Captopril
- Clozapine
- Corticotropin
- Corticosteroids
- Desipramine
- Ethosuximide
- Indomethacin
- Niacin
- Niacinamide
- Nortriptyline
- Olsalazine
- Procainamide
- Rifampin
- Sulfamethoxazole
- Triazolam
- Other conditions:
- Acute stress (epinephrine or glucocorticoid stimulation)
- Acute inflammation
- Cushing's syndrome
References
- Abramson, N. Leukocytosis: Basics of Clinical Assessment. Am Fam Phy. 2000 Nov 1;62(9):2053-60.
- Amar D et al. Leukocytosis and increased risk of atrial fibrillation after general thoracic surgery. Ann Thorac Surg. 2006 Sep;82(3):1057-61; discussion 1061-2.
- Behrman: Nelson Textbook of Pediatrics, 17th ed. Chapter 710.
- LabTestsOnline®. White Blood Cell Count. [Homepage on the Internet] © 2001-2006. Last reviewed on May 6, 2005. Last accessed onOctober 17, 2006. Available at URL: http://www.labtestsonline.org/understanding/analytes/wbc/#how
- Mariani M et al. Significance of total and differential leucocyte count in patients with acute myocardial infarction treated with primary coronary angioplasty. Eur Heart J. 2006 Aug 21; [Epub ahead of print]
- Sanchez-Ramon S et al. Low blood CD8+ T-lymphocytes and high circulating monocytes are predictors of HIV-1-associated progressive encephalopathy in children. Pediatrics. 2003 Feb;111(2):E168-75.
- Sezer M et al. Association of Hematological Indices with the Degree of Microvascular Injury in Patients with Acute Anterior Wall Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention. Heart 2006 Aug 29; [Epub ahead of print].
- http://www.med-ed.virginia.edu/courses/path/innes/wcd/leukocytosis.cfm
- http://www.med-ed.virginia.edu/courses/path/innes/wcd/leukopenia.cfm