White blood cells help diagnose anemia
What does a differential blood count include?
The doctor uses it to measure the number of white and red blood cells. The leukocytes are divided into three groups:
- granulocytes ,
- monocytes ,
Each species is responsible for a different task in the defense against pathogens. The lymphocytes produce antibodies against infectious agents and altered body cells . They recognize each one and are able to fight them appropriately. Monocytes absorb foreign material and render it harmless. They phagocytose unwanted invaders and usually ensure that no disease breaks out.
With the differential blood count, the specialist determines the value of the leukocytes in anemia in number of cells per liter. It also includes the values of the three subgroups. The granulocytes are further divided into basophilic, eosinophilic and neutrophilic. Due to their shape, the latter are differentiated as segmented and rod-nucleated cells. Each species has its own purpose and its value is meaningful.
Interesting facts about leukocytes
Leukocytes and anemia are closely related. It is important to distinguish the individual types in order to determine the cause of the anemia. The various white blood cells come from the bone marrow and have a common progenitor cell. Thanks to special growth factors, different leukocytes develop from the pluripotent stem cell. They perform various tasks in the immune system.
The important parameters of the leukocytes in anemia include the grain-like granulocytes. Eosinophils, basophils and neutrophils take care of different types of pathogens. They differ in the way they defend themselves against infections. Their lifespan is seven hours. They circulate in the blood or are located on the inner walls of blood vessels before they are broken down. They move on by themselves. Therefore, some of them leave the bloodstream and often migrate to tissues and mucous membranes. They survive there for up to five days.
Neutrophilic granulocytes are mainly dormant in the spleen and lungs. In stressful situations such as adrenaline or cortisone effects, rapid mobilization is possible. Their numbers multiply extremely quickly at the onset of an infection as they phagocytose tissue debris and bacteria. The number of this type of leukocytes is too low in anemia. The normal value is 3,200 to 6,200 / µl. This corresponds to a relative value of 55 to 75 percent.
The role of monocytes and lymphocytes
Monocytes do not stay in the blood for long, but quickly migrate to the tissues. There they transform into scavenger cells and do their job of rendering bacteria harmless. They present the foreign bodies to the lymphocytes, which then mobilize their defense mechanisms. The ideal level is 2 to 10 percent of the total white blood cell count. The absolute value is 200 to 800 / µl. In the case of aplastic anemia, monocytopenia, a reduction in the number of monocytes, is visible in the blood count.
Bone marrow dysfunction causes this type of anemia. Leukocyte production is reduced. The patient also suffers from platelet and erythrocyte deficiency. The condition is rare and can be congenital or acquired. In most cases, no cause of the disease can be identified.
Lymphocytes as triggers of aplastic anemia
There are two types of lymphocytes in the blood: T-lymphocytes mature in the thymus. They recognize foreign bodies directly. The B lymphocytes produce antibodies. They use these specifically against suitable antigens. They come from the MALT or from the lymph nodes. The activity of the lymphocytes is directed, among other things, against the body’s own cells such as those of a tumor.
In aplastic anemia, they mistakenly attack the progenitor cells of red blood cells, granulocytes and platelets. They attack the blood stem cells, from which these immensely important cells in the blood develop. Instead of attacking foreign bodies as police, these types of leukocytes sometimes react to the wrong signal in anemia. They normally hold the office of the police and, thanks to a sophisticated self-recognition system, they only attack cells that are foreign to the body.
In the case of aplastic anemia, they no longer fulfill this function. The triggers of the false signals are unclear. dr medical Monika Führer, a doctor at the Munich University Hospital, suggests that in rare cases the surface structures of the body’s own cells and viruses are similar. It is based on research results known to it. A surface mutation due to changes in genetic material or exposure to chemicals is also likely. As a result, the lymphocytes no longer recognize the cell and destroy it.
Diagnosis and differentiation of anemia based on various parameters
The value of the leukocytes plays a decisive role in anemia. Due to its isolated evaluation, it is impossible to make a finding. They are only part of a comprehensive diagnostic scheme. Anemia has various causes. Therefore, thorough analysis of the differential blood count is of great importance.
In addition to the leukocytes, the erythrocyte indices are also part of it. These are the red blood cell counts. The following sizes are part of it:
- Hemoglobin,
- hematocrit,
- erythrocyte count.
This information provides important information related to anemia.
The following values are also included in the diagnosis:
- iron metabolism (ferritin, iron and transferrin),
- folic acid,
- Vitamin B12,
- reticulocyte count.
The proportion of immature erythrocytes (reticulocytes) in the total number of red blood cells indicates whether the anemia is hyper-regenerative or hypo-regenerative.
The former is anemia with increased cell formation. The number of reticulocytes is over 70,000 per microliter of blood. The latter is anemia with reduced cell regeneration. The number of immature red blood cells is less than 30,000 per microliter of blood. The combination of different numbers from the differential blood count and the other measured values provides information about the type of anemia.
The correct interpretation of the leukocyte values
The value of the leukocytes in anemia can be interpreted differently. If the iron level is low, an anemia from an infection or a tumor is likely. In this case, the leukocytes are significant. Another important parameter for classifying the present anemia is the mean corpuscular volume (MCV). This denotes the average volume of erythrocytes.
The hematocrit divided by the erythrocyte count gives the MCV, which normally ranges from 83 to 97 femtoliters (1 fl = one quadrillionth of a liter). Based on this value, anemia is divided into three classes:
- low MCV: microcytic anemia,
- normal MCV: normocytic anemia,
- high MCV: macrocytic anemia.
In the case of normocytic anemia, the leukocytes must be taken into account. If these are also in the normal range, the iron parameters are usually decisive.
The differential blood count is the basis of anemia diagnosis
If anemia is suspected, the leukocytes are one of the decisive parameters. They indicate whether there is a bone marrow disorder or an infection. The white blood cells are divided into various subgroups, each of which has its own importance in the diagnosis of anemia. In anemia, the leukocytes should never be considered in isolation. Only in connection with iron and/or the erythrocytes do they give a clear picture. A specialist recognizes the type of anemia and derives the correct therapy approach.
Medical note for our readers:
Our patient information explains medical topics in a simple and understandable way. Our information is not a substitute for a medical examination. Please see a specialist for diagnosis or treatment.
