The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are any abnormal or immature cells.
Differential; Diff; White blood cell differential count
A blood sample is needed.
A laboratory specialist takes a drop of blood from your sample and smears it onto a glass slide. The smear is stained with a special dye, which helps tell the difference between various types of white blood cells.
Five types of white blood cells, also called leukocytes, normally appear in the blood:
A special machine counts the number of each type of cell. The test shows if the number of cells are in proper proportion with one another, and if there is more or less of one cell type.
No special preparation is necessary.
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.
The different types of white blood cells are given as a percentage of all white cells:
Any infection or acute stress increases your number of white blood cells. High white blood cell counts may be due to inflammation, an immune response, or blood diseases such as leukemia. Abnormal or immature white blood cells may indicate leukemia or bone marrow invasion by cancer or infection.
It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.
An increased percentage of neutrophils may be due to:
A decreased percentage of neutrophils may be due to:
An increased percentage of lymphocytes may be due to:
A decreased percentage of lymphocytes may be due to:
An increased percentage of monocytes may be due to:
An increased percentage of eosinophils may be due to:
An increased percentage of basophils may be due to:
A decreased percentage of basophils may be due to:
There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another, and from one side of the body to the other. Taking blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight, but may include:
Bain BJ. The peripheral blood smear. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 148.
Nasr MR, Hutchison RE. Leukocytic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 34.
Reviewed By: Mark Levin, MD, Hematologist and Oncologist, Monsey, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.