Skip to main content
Your session has expired. Reloading...
Hematology

Leukocyte differential: the five kinds of white blood cells and what a deviation means

According to the NVKC, the Dutch society of clinical chemists, white blood cells are made in the bone marrow and protect the body against infections by bacteria, viruses or parasites. According to the NVKC, there are five kinds: neutrophils, lymphocytes, monocytes, eosinophils and basophils, and the leukocyte differential counts each kind separately.

According to the NVKC, a raised neutrophil count occurs with a bacterial infection, a raised lymphocyte count is usually the result of a viral infection, and a raised eosinophil count usually points to an allergic reaction or a parasitic infection. According to the NVKC, a low neutrophil count is usually caused by medicines. Only a blood test shows how many white blood cells of each kind are in the blood.

For adults, Star-SHL uses separate limits per kind, for example 1.8 to 7.3 × 10⁹/l neutrophils and 1.5 to 4.0 × 10⁹/l lymphocytes.

Doctor's Assessment Included

The leukocyte differential counts the white blood cells, the cells of the immune system, by type: neutrophils, lymphocytes, monocytes, eosinophils and basophils. Each type has its own normal value, which can differ between laboratories.

  • For adults, Star-SHL uses 1.8 to 7.3 × 10⁹/l neutrophils and 1.5 to 4.0 × 10⁹/l lymphocytes; for everyone older than 15, Unilabs uses 1.5 to 7.5 × 10⁹/l neutrophils and 1.0 to 3.5 × 10⁹/l lymphocytes.
  • When the leukocyte differential is abnormal, Star-SHL also examines the blood under the microscope.

Leukocyte Differential: what this test measures

The leukocyte differential counts, per kind of white blood cell, how many cells are in the blood, expressed in billions of cells per litre (10⁹/l). Star-SHL, Unilabs, Certe and Diagnostiek voor U each give separate limits per kind; Diagnostiek voor U writes the unit as /nL, which gives the same number.

According to a 2015 review in American Family Physician, it is sometimes helpful to think in absolute counts rather than percentages; an absolute count is the total white blood cell count times the percentage of one kind.

Leukocyte Differential: why this value matters

According to the NVKC, the leukocyte differential is done to determine the nature, amount and function of the five kinds of white blood cells and so to examine how the immune system works. According to the NVKC, the test can show whether the immune system is sufficiently able to fight infections, and it is also used to diagnose bone marrow disorders and/or blood cancer (leukaemia) and follow their course.

Leukocyte Differential: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
Blood count checkup · €109,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Leukocyte Differential: when is testing worthwhile?

According to the NVKC, a leukocyte differential is usually part of a complete blood count, which a doctor can request for a very wide range of conditions. When the differential is abnormal, Star-SHL also examines the blood under the microscope.

Leukocyte Differential: symptoms of a high or low value

Low Levels

According to the NVKC, a low neutrophil count in the leukocyte differential is usually caused by medicines, especially painkillers and antibiotics; according to the NVKC, serious infections such as typhoid and hepatitis, and ionising radiation, can also lead to fewer neutrophils. According to the NVKC, a low lymphocyte count is uncommon and can be caused by HIV infection, malnutrition, vitamin deficiencies or loss of lymphocytes in the gut. For basophils, Unilabs and Diagnostiek voor U give an upper limit only.

High Levels

According to the NVKC, a raised neutrophil count in the leukocyte differential occurs with a bacterial infection and with other inflammation, such as serious injuries, burns and tumours, and with some kinds of blood cancer. According to the NVKC, a raised lymphocyte count is usually the result of an infection with a virus and sometimes with a bacterium, and a raised eosinophil count usually points to a parasitic infection or an allergic reaction such as hay fever, asthma or food allergy.

According to a 2015 review in American Family Physician, a raised white blood cell count is a suggestive, but not definitive, sign of a serious infection.

Leukocyte Differential: causes of a low or high value

What lowers the value

  • Medicines

    A low neutrophil count is usually caused by medicines, especially painkillers and antibiotics.

  • Black African descent

    People of Black African descent tend to have lower white cell and neutrophil counts.

  • Few lymphocytes (uncommon)

    A low lymphocyte count is uncommon and can be caused by HIV infection, malnutrition, vitamin deficiencies or loss of lymphocytes through the gut.

What raises the value

  • Bacterial infection or inflammation

    In a bacterial infection and other inflammation, such as serious injuries and burns, the neutrophil count can rise.

  • Viral infection

    A raised lymphocyte count is usually caused by a viral infection.

  • Allergy or parasites

    A raised eosinophil count usually points to a parasitic infection or an allergic reaction such as hay fever, asthma or food allergy.

  • Exercise, stress, smoking, obesity or medicines

    Exercise, emotional stress, smoking, obesity and some medicines, such as corticosteroids, can raise the white cell count.

  • Blood cancer

    In some types of blood cancer the neutrophil count can be raised.

Leukocyte Differential: lifestyle and this value

An abnormal leukocyte differential is one to discuss with your GP. According to a 2015 review in American Family Physician, for a raised white blood cell count the first laboratory tests should include a repeat full blood count, with the differential and a review of the blood under the microscope.

Leukocyte Differential: frequently asked questions

Why do reference values differ between laboratories?

According to the NVKC, the reference values of the leukocyte differential can differ between laboratories, and for neutrophils they depend on the measuring method. Star-SHL uses 1.8 to 7.3 × 10⁹/l neutrophils for adults, Certe 1.8 to 7 × 10⁹/L for people older than 18 and Unilabs 1.5 to 7.5 × 10⁹/l for people older than 15.

Do children have different values?

Yes, according to the NVKC higher lymphocyte values are found in children under 15, and Unilabs gives separate limits for the leukocyte differential by age, from the first days of life.

What are basophils?

Basophils are one of the five kinds of white blood cells in the leukocyte differential, and according to the NVKC they contain substances that are released in allergic reactions and can cause redness and itching. Because basophils work mainly in tissues affected by allergy, their number in the blood does not say much, according to the NVKC.

Leukocyte Differential: sources

  1. NVKC, Alles over testen: Neutrofiele granulocyten, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
  2. Riley LK, Rupert J. Evaluation of Patients with Leukocytosis. Am Fam Physician 2015;92(11):1004-1011. (retrieved 2026) aafp.org
  3. NVKC, Alles over testen: Lymfocyten, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
  4. NVKC, Alles over testen: Eosinofiele granulocyten, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl

Test Products

This marker is included in the following test panels.

Blood count & immunity

Blood count checkup

A blood test with 10 values for blood count and immunity — haemoglobin, haematocrit, white cells with differential, platelets, MCV, MCH, MCHC, CRP and ESR — for insight into blood and inflammation.

Hemoglobin Hematocrit Leukocytes (WBC) Leukocyte Differential Platelets (Thrombocytes) MCV (Mean Corpuscular Volume) MCH (Mean Corpuscular Hemoglobin) MCHC (Mean Corpuscular Hemoglobin Concentration) CRP (C-Reactive Protein) Erythrocytes (RBC) Ferritin
€109,-

Medical reviewer

Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
CIBG Ministerie van Volksgezondheid,
Welzijn en Sport Official BIG registration BIG 49928676701 Opens in a new tab

Leukocyte Differential

€13,-