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How to Calculate a Left Shift
When you get your blood tested, there are three main counts that doctors look at: red blood cells, white blood cells and platelets. White blood cells are of particular interest as they act as the body's first line of defense against infectious diseases and harmful foreign substances. These cells are further categorized into different types of white blood cells, including the total count, neutrophils, eosinophils, basophils, lumphocytes and monocytes. Considering them in that order, when the percentages increase on the first few types and decrease on the latter types, it is known as a left shift.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Determine the baseline values for each of these types of white blood cells, as well as the total white blood cell count 1. The total count for a healthy adult is anywhere between 4,000 and 11,000 cells per microliter, according to medterms.com.
What Is a Shift to the Left in Blood Testing?
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Calculate the percentages of each white blood cell type in the following order: neutrophils, eosinophils, basophils, lumphocytes then finally monocytes 1. This is done by dividing the individual counts of each type by the total white blood cell count 1.
Take a second blood sample when the patient is sick. The total white blood cell count should be significantly higher than the baseline 1.
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Calculate the percentages of white blood cell types, paying particular attention to the neutrophils 1. When a patient is suffering from one of a number of ailments, including eclampsia, gout, rheumatoid arthritis, leukemia and trauma, among others, the percentages of white blood cell types will change 1. The calculated distribution will shift to the left with elevated neutrophil counts.
Tips
In the days when test results were written down by hand, the neutrophil percentage was conventionally the first type written down. Because our writing is recorded from left to right, when the neutrophil count is increased, it became known as a left shift.
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References
- Medterms: White Blood Cell Definition
- Rnceus: Complete Blood Count with Differential
- US National Library of Medicine: Blood Differential
- Lab Tests Online: Complete Blood Count: Test Sample
- Mayadas TN, Cullere X, Lowell CA. The multifaceted functions of neutrophils. Annu Rev Pathol. 2014;9:181-218. doi:10.1146/annurev-pathol-020712-164023
- Mcbrien CN, Menzies-gow A. The Biology of Eosinophils and Their Role in Asthma. Front Med (Lausanne). 2017;4:93. doi:10.3389/fmed.2017.00093
- Cromheecke JL, Nguyen KT, Huston DP. Emerging role of human basophil biology in health and disease. Curr Allergy Asthma Rep. 2014;14(1):408. doi:10.1007/s11882-013-0408-2
- Hoffman W, Lakkis FG, Chalasani G. B Cells, Antibodies, and More. Clin J Am Soc Nephrol. 2016;11(1):137-54. doi:10.2215/CJN.09430915
- Karlmark KR, Tacke F, Dunay IR. Monocytes in health and disease - Minireview. Eur J Microbiol Immunol (Bp). 2012;2(2):97-102. doi:10.1556/EuJMI.2.2012.2.1
- Görgens A, Radtke S, Horn PA, Giebel B. New relationships of human hematopoietic lineages facilitate detection of multipotent hematopoietic stem and progenitor cells. Cell Cycle. 2013;12(22):3478-82. doi:10.4161/cc.26900
- Hong JW, Noh JH, Kim DJ. Association between White Blood Cell Counts within Normal Range and Hemoglobin A1c in a Korean Population. Endocrinol Metab (Seoul). 2018;33(1):79-87. doi:10.3803/EnM.2018.33.1.79
- Riley LK, Rupert J. Evaluation of Patients with Leukocytosis. Am Fam Physician. 2015;92(11):1004-11.
- Flores-mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269-84. doi:10.1038/nrmicro3432
- Kasi PM, Grothey A. Chemotherapy-Induced Neutropenia as a Prognostic and Predictive Marker of Outcomes in Solid-Tumor Patients. Drugs. 2018;78(7):737-745. doi:10.1007/s40265-018-0909-3
- U.S. Library of Medicine. MedlinePlus. White Blood Cell Count. https://medlineplus.gov/ency/article/003643.htm
Tips
- In the days when test results were written down by hand, the neutrophil percentage was conventionally the first type written down. Because our writing is recorded from left to right, when the neutrophil count is increased, it became known as a left shift.
Writer Bio
A professional travel writer since April 2010, Doug Leenhouts has written for world66.com and slowtrav.com. He has a Bachelor of Science in management information systems from the Worcester Polytechnic Institute and three years of service in a consulting firm.