Hemogram and Differential

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The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Absolute Band Neutrophils

Immature forms of neutrophils are called neutrophilic band cells. Neutrophils are a type of white blood cell that is responsible for much of the body's protection against infection. Neutrophils are produced in the bone marrow and released into the bloodstream to travel to wherever they are needed. Large numbers of immature forms of neutrophils, called neutrophilic band cells, are produced by the bone marrow when the demand is high.

Absolute Basophils

Basophils normally constitute 1% or less of the total white blood cell count but may increase or decrease in certain diseases and are thought to be involved in allergic reactions.

Absolute Blasts

Blasts are immature forms of white blood cells.

Absolute Eosinophils

Eosinophils (eos) respond to infections caused by parasites and play a role in allergic reactions (hypersensitivities)

Absolute Lymphocytes

Lymphocytes are white blood cells that exist in both the blood and the lymphatic system. They are divided into three types. The B lymphocytes (B cells) are antibody-producing cells that are essential for acquired, antigen-specific immune responses. The second type are T lymphocytes (T cells) some T cells help the body distinguish between "self" and "non-self" antigens while others initiate and control the extent of an immune response, boosting it as needed and then slowing it as the condition resolves. Other types of T cells directly attack and neutralize virus-infected or cancerous cells. The third type are natural killer cells (NK cells) that directly attack and kill abnormal cells such as cancer cells or those infected with a virus.

Absolute Metamyelocytes

Metamyelocytes are immature forms of white blood cells.

Absolute Monocytes

Monocytes (mono), similar to neutrophils, move to an area of infection and engulf and destroy bacteria. They are associated more often with chronic rather than acute infections. They are also involved in tissue repair and other functions involving the immune system.

Absolute Myelocytes

Myelocytes are immature forms of white blood cells.

Absolute Neutrophils

Neutrophils (neu) normally make up the largest number of circulating WBCs. They move into an area of damaged or infected tissue, where they engulf and destroy bacteria or sometimes fungi. Young neutrophils, recently released into circulation, are called bands.

Absolute Nucleated Rbc

Nucleated Red Blood Cells (nRBC) ) the presence of NRBCs in the adult blood is usually associated with malignant neoplasms, bone marrow diseases, and other serious disorders.

Absolute Promyelocytes

Promyelocytes are immature forms of white blood cells.

Band Neutrophils

Immature forms of neutrophils are called neutrophilic band cells. Neutrophils are a type of white blood cell that is responsible for much of the body's protection against infection. Neutrophils are produced in the bone marrow and released into the bloodstream to travel to wherever they are needed. Large numbers of immature forms of neutrophils, called neutrophilic band cells, are produced by the bone marrow when the demand is high.

Basophils

Basophils normally constitute 1% or less of the total white blood cell count but may increase or decrease in certain diseases and are thought to be involved in allergic reactions.

Blasts

Blasts are immature forms of white blood cells.

Eosinophils

Eosinophils (eos) respond to infections caused by parasites and play a role in allergic reactions (hypersensitivities)

Hematocrit

Hematocrit is a blood test that measures the percentage of the volume of whole blood that is made up of red blood cells. This measurement depends on the number of red blood cells and the size of red blood cells.

Hemoglobin

Serum hemoglobin is a blood test that measures the level of free hemoglobin in the liquid part of the blood (the serum). Free hemoglobin is the hemoglobin outside of the red blood cells. Most of the hemoglobin is found inside the red blood cells, not in the serum.

Lymphocytes

Lymphocytes are white blood cells that exist in both the blood and the lymphatic system. They are divided into three types. The B lymphocytes (B cells) are antibody-producing cells that are essential for acquired, antigen-specific immune responses. The second type are T lymphocytes (T cells) some T cells help the body distinguish between "self" and "non-self" antigens while others initiate and control the extent of an immune response, boosting it as needed and then slowing it as the condition resolves. Other types of T cells directly attack and neutralize virus-infected or cancerous cells. The third type are natural killer cells (NK cells) that directly attack and kill abnormal cells such as cancer cells or those infected with a virus.

MCH

Mean corpuscular hemoglobin (MCH) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell.

MCHC

Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average percentage of hemoglobin inside a red cell.

MCV

Mean corpuscular volume (MCV) is a measurement of the average size of RBCs.

Metamyelocytes

Metamyelocytes are immature forms of white blood cells.

Monocytes

Monocytes (mono), similar to neutrophils, move to an area of infection and engulf and destroy bacteria. They are associated more often with chronic rather than acute infections. They are also involved in tissue repair and other functions involving the immune system.

Myelocytes

Myelocytes are immature forms of white blood cells.

Neutrophils

Neutrophils are a type of white blood cell that is responsible for much of the body's protection against infection. Neutrophils are produced in the bone marrow and released into the bloodstream to travel to wherever they are needed.

Nucleated Rbc

Nucleated Red Blood Cells (nRBC) ) the presence of NRBCs in the adult blood is usually associated with malignant neoplasms, bone marrow diseases, and other serious disorders.

Promyelocytes

Promyelocytes are immature forms of white blood cells.

Reactive Lymphocytes

Lymphocytes are white blood cells that exist in both the blood and the lymphatic system. They are divided into three types. The B lymphocytes (B cells) are antibody-producing cells that are essential for acquired, antigen-specific immune responses. The second type are T lymphocytes (T cells) some T cells help the body distinguish between "self" and "non-self" antigens while others initiate and control the extent of an immune response, boosting it as needed and then slowing it as the condition resolves. Other types of T cells directly attack and neutralize virus-infected or cancerous cells. The third type are natural killer cells (NK cells) that directly attack and kill abnormal cells such as cancer cells or those infected with a virus.

Red Blood Cell Count

An RBC count is a blood test that tells how many red blood cells (RBCs) you have. RBCs contain hemoglobin, which carries oxygen. How much oxygen your body tissues get depends on how many RBCs you have and how well they work.

White Blood Cell Count

A WBC count is a test to measure the number of white blood cells (WBCs) in the blood. WBCs help fight infections. They are also called leukocytes. There are five major types of white blood cells: basophils, eosinophils, lymphocytes (T cells and B cells), monocytes and neutrophils
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The Hemogram and Differential test contains 1 test with 30 biomarkers.

Brief Description: The Hemogram and Differential test, more commonly known as the Complete Blood Count (CBC) with Differential, is a comprehensive blood test that provides information about various cells present in the blood. It measures the count, size, hemoglobin content, and other characteristics of red blood cells, white blood cells, and platelets.

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When and Why a Hemogram and Differential Test May Be Ordered

The Hemogram and Differential test is one of the most frequently ordered blood tests because of its utility in diagnosing and monitoring a wide variety of conditions. Reasons for ordering include:

  1. Routine Health Examination: As a part of a general health check-up or physical examination.
  2. Diagnosis: To help diagnose certain conditions like anemia, infection, inflammation, bleeding disorder, or leukemia.
  3. Monitoring: To monitor medical conditions, like kidney disease or HIV, and to see how conditions are responding to treatment.
  4. Medication Monitoring: To monitor potential side effects of medications that may affect blood cells.

What the Hemogram and Differential Test Checks For

The Hemogram and Differential test measures several components:

  • Red Blood Cells (RBC) Count: Determines the number of RBCs in the blood, helping identify conditions like anemia or polycythemia.

  • Hemoglobin: The oxygen-carrying protein in RBCs. Low levels can indicate anemia.

  • Hematocrit: Percentage of total blood volume occupied by RBCs. Changes can indicate anemia or dehydration, among other conditions.

  • White Blood Cells (WBC) Count: Measures the total number of WBCs in the blood. Elevated or reduced numbers can indicate infections, blood disorders, or other diseases.

  • Differential WBC Count: Breaks down the WBCs into five main types – neutrophils, lymphocytes, monocytes, eosinophils, and basophils – providing insight into possible reasons for illnesses.

  • Platelet Count: Determines the number of platelets, which are essential for blood clotting.

Other Lab Tests Ordered Alongside Hemogram and Differential Test

When a Hemogram and Differential test is ordered, it's often part of a broader evaluation of a patient's general health or to investigate specific symptoms like anemia, infection, inflammation, and bleeding disorders. Here are some tests commonly ordered alongside it:

  1. Erythrocyte Sedimentation Rate (ESR):

    • Purpose: To measure the rate at which red blood cells settle in a tube over a specified period, an indirect marker of inflammation.
    • Why Is It Ordered: To help detect inflammation associated with conditions such as infections, cancers, and autoimmune diseases.

  2. C-Reactive Protein (CRP):

    • Purpose: To measure the level of CRP, a protein that increases in the blood with inflammation.
    • Why Is It Ordered: To assess acute or chronic inflammation, often in conjunction with ESR.

  3. Comprehensive Metabolic Panel:

    • Purpose: To assess general health status, kidney function, blood sugar levels, and electrolyte balance.
    • Why Is It Ordered: To provide more comprehensive information about the body's metabolic state and organ function.

  4. Iron Studies:

    • Purpose: To evaluate the body's iron stores and transport capability.
    • Why Is It Ordered: To diagnose iron deficiency or iron overload, common causes of anemia.

  5. Prothrombin Time - PT, Activated Partial Thromboplastin Time - aPTT:

    • Purpose: To assess the blood's ability to clot properly.
    • Why Is It Ordered: To evaluate coagulation disorders, especially if there is a history of abnormal bleeding or bruising.

  6. Vitamin B12 and Folate Tests:

    • Purpose: To measure the levels of these vitamins, which are crucial for red blood cell production.
    • Why Is It Ordered: To identify vitamin deficiencies that can cause anemia.

  7. Reticulocyte Count:

    • Purpose: To measure the number of reticulocytes (immature red blood cells) in the blood.
    • Why Is It Ordered: To determine whether the bone marrow is producing red blood cells at an appropriate rate.

  8. Urinalysis:

    • Purpose: To analyze the content of urine.
    • Why Is It Ordered: To screen for a variety of disorders, such as urinary tract infections, kidney disease, and diabetes.

These tests, when ordered alongside a Hemogram and Differential, provide a comprehensive overview of a patient’s health, offering valuable insights into various physiological processes and potential pathologies. They can help diagnose a wide range of conditions, from infections and inflammatory diseases to anemias and clotting disorders. The specific combination of tests will depend on the individual’s symptoms, medical history, and the reason for the blood work.

Conditions or Diseases that Require a Hemogram and Differential Test

The Hemogram and Differential test can help diagnose or monitor:

  • Anemia: Reduced number of red blood cells or low hemoglobin levels.

  • Leukemia: A type of blood cancer affecting white blood cells.

  • Infection: Elevated white blood cell count often signals an ongoing infection.

  • Inflammatory Disorders: Conditions like rheumatoid arthritis can cause changes in WBC counts.

  • Bleeding Disorders: Low platelet counts can be a sign of disorders affecting blood clotting.

Usage of Results from Hemogram and Differential Test by Health Care Providers

Healthcare providers use the results to:

  1. Diagnosis: As mentioned, a CBC with Differential can diagnose conditions like anemia, infections, and certain types of leukemia.

  2. Determine Severity: In conditions like anemia, the severity (mild, moderate, severe) can be gauged based on the results.

  3. Guide Treatment: Information on the type and cause of anemia or the nature of an infection can guide treatment strategies.

  4. Monitoring: Ongoing conditions or the effects of treatments (like chemotherapy) can be monitored using repeated CBCs with Differential.

In sum, the Hemogram and Differential test is a fundamental diagnostic tool in medicine, providing vital insights into a patient's health and guiding both diagnostic and therapeutic decisions.

Most Common Questions About the Hemogram and Differential test:

Purpose and Clinical Indications

Why is the Hemogram and Differential test ordered?

The Hemogram and Differential test is typically ordered to provide a broad overview of a patient's overall health, especially when checking for conditions like anemia, infection, inflammation, and several other disorders. It measures various components of the blood, including red blood cells, white blood cells, and platelets.

How does the Hemogram and Differential test differ from a Complete Blood Count (CBC)?

While the Hemogram and Differential test is often used interchangeably with the term CBC, they are essentially the same. Both tests evaluate the three major types of cells in the blood. The "differential" part specifically refers to a detailed count of the different types of white blood cells.

Interpretation of Results

What do abnormal results in the Hemogram and Differential test indicate?

Abnormal results can mean a variety of conditions, depending on which component of the blood is abnormal:

  • A high or low red blood cell count could indicate conditions like anemia, dehydration, or bone marrow disorders.
  • Abnormal white blood cell counts might suggest infections, inflammatory conditions, immune disorders, or blood cancers.
  • Platelet count changes can be linked to bleeding disorders, bone marrow issues, or an enlarged spleen.

In the Hemogram and Differential test, what is meant by the term "differential"?

In the context of the Hemogram and Differential test, the "differential" refers to a detailed breakdown of the different types of white blood cells. It can help identify infections, inflammation, allergies, or potential diseases of the bone marrow or immune system.

Implications and Medical Management

If I have abnormal results from the Hemogram and Differential test, what's the next step?

If your Hemogram and Differential test results are abnormal, your healthcare provider will likely recommend further tests to determine the cause of the abnormalities. The specific follow-up will depend on which values are out of the normal range and your clinical symptoms.

Is the Hemogram and Differential test used to monitor certain treatments or medications?

Yes, the Hemogram and Differential test is often used to monitor treatments or medications that might impact blood cells. For example, it's frequently ordered during chemotherapy, which can affect bone marrow and lead to changes in blood cell counts.

Test Specifics

Why is the Hemogram and Differential test frequently ordered during routine medical exams?

The Hemogram and Differential test provides a comprehensive overview of one's health, making it a valuable tool during routine medical exams. Abnormalities can act as early indicators for various medical conditions, even before symptoms are apparent, allowing for early intervention and management.

Special Considerations

Can the Hemogram and Differential test differentiate between bacterial and viral infections?

While the test doesn't directly detect bacteria or viruses, the pattern of white blood cell changes can give clues. For instance, a high neutrophil count often indicates a bacterial infection, while an elevated lymphocyte count can suggest a viral infection. However, further tests are usually necessary for a definitive diagnosis.

Post-Test Management

If the Hemogram and Differential test indicates anemia, how is the type of anemia determined?

If the Hemogram and Differential test suggests anemia (a low red blood cell count), additional tests will be necessary to determine its type and cause. These might include tests for vitamin deficiencies, iron studies, reticulocyte count, and other specific tests depending on the suspected cause.

Test Limitations

Are there conditions or situations where the Hemogram and Differential test might not be useful or informative?

While the Hemogram and Differential test is broadly informative, it's a screening tool and not definitive. There are cases, especially in early stages of diseases or in mild conditions, where the test results may be within normal ranges. It's crucial to consider clinical symptoms and other diagnostic tools when evaluating a patient's health.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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