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I'm a bit uncertain of what exactly the Segs. and Bands mean in a lab diff. Also, in a viral condition, is it possible for the lymphocyte count to be elevated while the WBC count remains normal?
kc361 said:I'm guessing the OP is asking what the *significance* of these items are in the differential, not necessarily their definition.
To the OP: Think about what a band cell is - an immature neutrophil. If the differential indicates increased WBC, with a high percentage of neutrophils (segs) and increased bands, this is referred to as a "left shift." It indicates that the bone marrow is working like the dickens to pump out new neutrophils in the setting of an acute infection. Increased bands usually carries a worse prognosis than an elevated WBC without bands.
scootad. said:Actually, while everyone seems to think they know what a left shift is, if you ask 3 people you will get 3 different answers! Its like gaydar, people know it when they see it but cant come to a consensus about what it is. Some think that the presence of bands alone (bandemia) is equivalent to a left shift. Others will say a higher than normal PMN % is equivalent to a left shift (with or without bands, with or without higher than normal white count). Still others will say a left shift is a higher than normal PMN % in the presence of a leukocytosis and a bandemia. I cant tell you how many times I've heard people use different definitions during my rotations.
whatever it is, it implies acute bacterial infection.
rxfudd said:Our immuno professor in 1st year was all too proud of the fact that he was one of the few people who actually know what the term left shift means. He says that historically, they used to use a counting device to record the differential on a CBC. The button that counted bands was the furthest button to the left, so when there was an acute infection/inflammation, you would be hitting that button much more frequently than usual because you had a bandemia (hence the term "left shift"). From that story, I would argue (and I've been told by most of my attendings) that a left shift is strictly an increase in immature cells (bands).
Our immuno professor in 1st year was all too proud of the fact that he was one of the few people who actually know what the term left shift means. He says that historically, they used to use a counting device to record the differential on a CBC. The button that counted bands was the furthest button to the left, so when there was an acute infection/inflammation, you would be hitting that button much more frequently than usual because you had a bandemia (hence the term "left shift").
Our immuno professor in 1st year was all too proud of the fact that he was one of the few people who actually know what the term left shift means. He says that historically, they used to use a counting device to record the differential on a CBC. The button that counted bands was the furthest button to the left, so when there was an acute infection/inflammation, you would be hitting that button much more frequently than usual because you had a bandemia (hence the term "left shift"). From that story, I would argue (and I've been told by most of my attendings) that a left shift is strictly an increase in immature cells (bands).