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Hematology

Leukocyte differential: allergy, pregnancy and the white blood cells

Eosinophils and basophils are two of the five kinds of white blood cells, the cells that according to the NVKC protect the body against bacteria, viruses and parasites. According to the NVKC, eosinophils play a role mainly in allergic reactions and parasitic infections, and basophils contain substances that are released in an allergic reaction.

According to the NVKC, a raised eosinophil count usually points to a parasitic infection or an allergic reaction, such as hay fever, asthma or food allergy, and a shortage of neutrophils is usually linked to medicines. Only a blood test shows how many white blood cells of each kind there are.

Certe uses 0 to 0.4 × 10⁹/L eosinophils and 0 to 0.2 × 10⁹/L basophils for women older than 18.

Doctor's Assessment Included

The leukocyte differential counts the white blood cells, the cells of the immune system, by type: neutrophils, lymphocytes, monocytes, eosinophils and basophils. Each type has its own normal value, which can differ between laboratories.

  • For adults, Star-SHL uses 1.8 to 7.3 × 10⁹/l neutrophils and 1.5 to 4.0 × 10⁹/l lymphocytes; for everyone older than 15, Unilabs uses 1.5 to 7.5 × 10⁹/l neutrophils and 1.0 to 3.5 × 10⁹/l lymphocytes.
  • When the leukocyte differential is abnormal, Star-SHL also examines the blood under the microscope.

Leukocyte Differential: what this test measures

According to the NVKC, a leukocyte differential counts the five kinds of white blood cells separately and gives a count per kind. For basophils, according to the NVKC, that is normally 0 to 2% of all white blood cells, or 0 to 0.2 × 10⁹ cells per litre.

Leukocyte Differential: why this value matters

According to the NVKC, a leukocyte differential helps examine the severity of allergic reactions and bacterial infections. According to the NVKC, the number of basophils in the blood does not say much, because basophils work mainly in tissues where allergic reactions take place, such as the skin, nose and lungs.

Leukocyte Differential: how the blood test works

Referral
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Leukocyte Differential: when is testing worthwhile?

According to the NVKC, a leukocyte differential with the eosinophil count can be useful for symptoms that point to an allergy or a parasitic infection, and according to the NVKC that count is always done as part of a complete blood count.

Leukocyte Differential: symptoms of a high or low value

Low Levels

According to the NVKC, a low lymphocyte count in the leukocyte differential is uncommon, and it can come from HIV infection, malnutrition, vitamin deficiencies or loss of lymphocytes in the gut.

High Levels

According to the NVKC, a raised basophil count in the leukocyte differential can be the result of various kinds of leukaemia, and also of exposure to toxic substances or of radiation; when the basophil rise comes from leukaemia, according to the NVKC, the eosinophil count is often raised as well. According to the NVKC, raised eosinophils are also found in eosinophilic leukaemia, the hypereosinophilic syndrome and some autoimmune diseases.

Leukocyte Differential: causes of a low or high value

What lowers the value

  • Medicines

    A low neutrophil count is usually caused by medicines, especially painkillers and antibiotics.

  • Black African descent

    People of Black African descent tend to have lower white cell and neutrophil counts.

  • Few lymphocytes (uncommon)

    A low lymphocyte count is uncommon and can be caused by HIV infection, malnutrition, vitamin deficiencies or loss of lymphocytes through the gut.

What raises the value

  • Bacterial infection or inflammation

    In a bacterial infection and other inflammation, such as serious injuries and burns, the neutrophil count can rise.

  • Viral infection

    A raised lymphocyte count is usually caused by a viral infection.

  • Allergy or parasites

    A raised eosinophil count usually points to a parasitic infection or an allergic reaction such as hay fever, asthma or food allergy.

  • Exercise, stress, smoking, obesity or medicines

    Exercise, emotional stress, smoking, obesity and some medicines, such as corticosteroids, can raise the white cell count.

  • Blood cancer

    In some types of blood cancer the neutrophil count can be raised.

Leukocyte Differential: lifestyle and this value

An abnormal leukocyte differential is one to discuss with the GP. According to a 2015 review in American Family Physician, it is important to use normal ranges that fit the age and any pregnancy when the white blood cell count is assessed.

Leukocyte Differential: frequently asked questions

Does the leukocyte differential change in pregnancy?

Yes, the leukocyte differential changes in pregnancy: according to a 2015 review in American Family Physician, the normal white blood cell count rises gradually, with a slight shift toward a higher percentage of neutrophils. According to that article, the 95% upper limit in the third trimester is 13.2 × 10⁹ white blood cells per litre.

Why do basophils cause redness and itching?

According to the NVKC, basophils, one of the five kinds in the leukocyte differential, contain substances that are released in allergic reactions, and those substances can cause redness and itching.

Leukocyte Differential: sources

  1. NVKC, Alles over testen: Neutrofiele granulocyten, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
  2. Riley LK, Rupert J. Evaluation of Patients with Leukocytosis. Am Fam Physician 2015;92(11):1004-1011. (retrieved 2026) aafp.org
  3. NVKC, Alles over testen: Lymfocyten, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
  4. NVKC, Alles over testen: Eosinofiele granulocyten, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl

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