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The peripheral blood contains white blood cells of several types in numbers and proportions that vary between quite narrow limits in health but more widely in disease.

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Normal White Blood Count & Differential

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As with many biologic parameters, there is no strict definition of normal; however, normal ranges are established by laboratories for their population group. Table 26-1 shows a typical set of normal laboratory values for the United States.

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Table 26–1. White Blood Cell Count (WBC), Differential: Normal Values.
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Variations in these parameters, along with changes in leukocyte morphology as seen in blood smears, are important indicators of disease (Table 26-2).

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Table 26–2. Broad Categories of Variation in Leukocyte Number and Morphology. 1
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Abnormalities in Lymphocyte Count

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Lymphocyte and monocyte origin and function have been considered with the immune system (Chapter 4: The Immune Response).

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Lymphocytosis—increased lymphocyte count in peripheral blood—is best considered in relationship to other lymphoproliferative diseases (Chapter 28: The Lymphoid System: I. Structure & Function; Infections & Reactive Proliferations). It may occur as (1) an acute immune response, with many activated or transformed lymphocytes circulating in the blood; (2) a chronic immune response, in which most of the circulating lymphocytes resemble resting small lymphocytes; or (3) neoplastic proliferation (Table 26-3).

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Table 26–3. Variation in Lymphocyte Parameters in Peripheral Blood.

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