[{"a":["Evgeny Zaytsev"],"b":"Written by Evgeny Zaytsev, physician in clinical laboratory diagnostics.\nWhat the differential count is # The differential white blood cell count — the leukogram, «leukoformula» in Russian — is the ratio of the different classes of white cells in the blood. Human white cells, like those of many animals, fall into five main types:\nNeutrophils — the largest fraction of white cells in adults. Lymphocytes — the group of blood cells that predominates in children. Monocytes — third by how often they are met in the blood. Eosinophils — cells everyone should have, at least in small numbers. Basophils — the rarest fraction, which healthy people may have too. Reading the differential count # Neutrophils # A raised neutrophil count (neutrophilia) is common in fever. The higher the body temperature, the higher the number of neutrophils in the blood.\nA left shift is a rise in immature band neutrophils. It is a sign of an inflammatory reaction, most often of infectious origin. In bacterial infections the band count is usually above 1500/µl. The German medical society considers a band proportion above 10 % to be a criterion of bacterial infection on its own. Band neutrophils are often seen in the blood of children and teenagers with infectious mononucleosis, alongside reactive lymphocytes (atypical mononuclear cells).\nA right shift is a rise in mature segmented neutrophils while the immature ","d":"What the differential count is, how to read neutrophils, lymphocytes, monocytes, eosinophils and basophils, and which pathological cells must never be missed.","s":"Article","t":"The differential white blood cell count","tg":["Neutrophils","Lymphocytes","Microscopy"],"tp":["Hematology"],"u":"/en/post/leukocyte-differential/"},{"a":["Darya Todzhaeva"],"b":"The clinical case was kindly provided by Darya Todzhaeva↗, physician in clinical laboratory diagnostics, Moscow.\nCritical blue-green inclusions, also known as blue-green neutrophilic inclusions and informally called «crystals of death», are amorphous blue-green cytoplasmic inclusions found in neutrophils and occasionally in monocytes.\nThey are found most often in critically ill patients, especially those with liver disease, and their presence in a peripheral blood smear is linked to high short-term mortality. The statistics show that 56 % of patients died soon after the inclusions were first seen — usually within two weeks.\nThe current view is that these critical green inclusions are most likely phagocytosed products of lysosomal degradation related to tissue injury.\nHere is the case of an 81-year-old woman admitted to intensive care with a diagnosis of sepsis. Her blood smear showed both Döhle bodies and blue-green inclusions.\nWhat the full blood count showed # Anaemia — haemoglobin 66 g/l, normocytic and normochromic, without anisocytosis. The reticulocyte count was 0.01 million/µl, which points to a hyporegenerative anaemia caused by suppressed erythropoiesis in the bone marrow.\nNormoblasts appearing in the peripheral blood while the reticulocyte count is low may be due to disturbed bone marrow architecture or, more likely, to a large release of inflammatory mediators, mainl","d":"A clinical case of an 81-year-old woman with sepsis: critical blue-green inclusions in neutrophils, Knyazkov — Döhle bodies and what they mean for the prognosis.","s":"Article","t":"«Blue-green crystals of death» and Döhle bodies in neutrophils","tg":["Neutrophils","Sepsis","Clinical case","Microscopy"],"tp":["Hematology"],"u":"/en/post/blue-green-death-crystals-and-dohle-bodies/"},{"a":[],"b":" What we do # Leukoformula is an educational project about laboratory diagnostics and hematology. We review blood and bone marrow smears, teach how to read the differential white blood cell count, and discuss staining techniques and clinical cases.\nWho writes the material # The school runs as an open platform: articles and slide photographs are published by the specialists themselves — teachers, laboratory physicians, technologists and students. Everything is moderated before it goes live.\nA note on language # The articles are written in Russian — that is the working language of our community. The photographs, however, need no translation: a smear looks the same in every language, and the captions are short enough for a dictionary.\nIf you work in laboratory medicine and would like to publish a case in English, write to us. We are glad to start.\nPractice without Russian\nThe trainer is a separate application where you examine digital smears and count cells. It works fine without knowing Russian — the interface is mostly numbers and cell names in Latin.\nWhat is here # Articles — blood and bone marrow morphology, clinical cases, diagnostic algorithms, laboratory methods. In Russian. Video courses — recorded lessons with slide review. In Russian. Libraries — collections of digital smears, methods and useful links. Trainer — practice counting cells on real slides. Hall of fame — the ","d":"Leukoformula is an online school of laboratory diagnostics and hematology. How the school works and who writes the material.","s":"","t":"About the school","tg":[],"tp":[],"u":"/en/about/"},{"a":[],"b":" Write to us # leukoformula@mail.ru↗ — questions about the school, courses and publishing your own material.\nWe answer in English and in Russian.\nCommunities # Most of the day-to-day life of the school happens in our communities, in Russian. Slide photographs and clinical findings are posted there daily.\nPublishing with us # Send us at least one photograph and a short description of the case. What matters is that the material has not been published anywhere else before — rarity of the finding does not matter at all.","d":"How to reach the Leukoformula school: email and communities.","s":"","t":"Contacts","tg":[],"tp":[],"u":"/en/contacts/"},{"a":[],"b":"The trainer is a game about recognising blood cells: a field of view appears, you name what you see, and the score tells you how close you are to the eye of a laboratory physician. The free version is open to everyone.\nPremium activation opens the full set and is included in level II «Band neutrophil» and above on Boosty. Follow the link below, subscribe, and the post with the activation key opens for you.","d":"Activate the full version of the «Leukoformula» blood cell trainer: every set of cells, no limits. Included in subscription level II and above.","s":"membership","t":"Premium mode in the blood cell trainer","tg":[],"tp":[],"u":"/en/membership/trainer-premium/"},{"a":[],"b":"The private library is a members-only collection of hematology books that the school has gathered over the years. It is the part of the subscription that works in any language: the books are professional editions, and most of them are in English.\nAccess opens at level II «Band neutrophil» on Boosty and stays with you at every level above. Follow the link below, subscribe, and the post with the library opens for you.","d":"A members-only collection of professional hematology books: principles and practice, laboratory methods, diagnosis and management of hematologic disorders. Opens at subscription level II.","s":"membership","t":"Private books: the laboratory hematology library","tg":[],"tp":[],"u":"/en/membership/private-books/"},{"a":["Evgeny Zaytsev"],"b":"Written by Evgeny Zaytsev, physician in clinical laboratory diagnostics.\nThe test gives us a single number, yet that number lets us suspect three different diseases at once. What other test can claim to be this informative? The «Leukoformula» team recommends it to everyone, and to women in particular.\nIron deficiency anaemia # A low serum ferritin is the gold-standard marker of iron deficiency. Most people tie the word «anaemia» to a lack of haemoglobin. But there is a special form — hidden anaemia, in which haemoglobin is still normal. It is called latent iron deficiency anaemia.\nThis is the most widespread disease on Earth: more than a billion people have it. Russian federal guidelines put the key threshold for the diagnosis at below 30 ng/ml.\nSymptoms of a low ferritin:\nhair loss; muscle weakness; apathy; a twitching eyelid; a fast heartbeat; shortness of breath on exertion. Inflammation in the body # Ferritin is an acute-phase protein. Inflammation is most often set off by an infection — bacterial, viral or other — though not necessarily.\nHereditary haemochromatosis # This disease used to be called «bronze diabetes», because an excess of iron turns the skin brown. Because of a mutation in the HFE gene the body cannot control how much iron it absorbs. It becomes overloaded with the metal ion, and the liver suffers most of all.\nIn this disease the ferritin concentration rises","d":"A single number points to hidden iron deficiency, inflammation and hereditary haemochromatosis. Why a ferritin below 30 ng/ml is already a diagnosis.","s":"Article","t":"The ferritin test — three targets with one shot","tg":["Ferritin","Anaemia"],"tp":["Lab test interpretation"],"u":"/en/post/ferritin/"},{"a":["Evgeny Zaytsev"],"b":"«Nature is conquered by the one who obeys her; when all her icons are understood, a person will become an unlimited ruler over her».\ndoctor, Veresaev Vikenty Vikentievich\nHello! My name is Evgeny Zaytsev, and I will tell you about the 5 main reasons for the increase in the level of lymphocytes in the blood.\nI work as a medical consultant. I am approached with questions about the interpretation of laboratory tests by phone, via WhatsApp, through social networks, on average about one thousand questions per month.\nYou will also learn why Russian doctors were the first to diagnose an increase in the level of lymphocytes. There will be many clinical examples from personal practice. But first, I’ll briefly cover the basics:\nTop 5 reasons:\nTypes of lymphocytes\nThe number of lymphocytes is examined in a general blood test with a leukocyte formula. Blood can be divided into 3 parts - plasma, erythrocytes (red cells) and leukocytes (white cells). “Leikos” is Greek for “white”. Leukocytes are divided into fractions of eosinophils, basophils, neutrophils, monocytes and lymphocytes. In turn, lymphocytes are divided into B-cell (lymphocytes), T-cell (lymphocytes). B-lymphocytes produce protective antibodies. T-lymphocytes are also divided into T-helpers and T-cytotoxic lymphocytes. Lymphocytes live from a week to several months, but some live for years, and are responsible for the immunologi","d":"A laboratory physician walks through the five most common reasons for lymphocytosis, with clinical examples: infections, reactive lymphocytes, smoking, spleen removal and chronic lymphocytic leukaemia.","s":"Article","t":"Top 5 causes of increased lymphocytes in the blood","tg":["Lymphocytes","Microscopy"],"tp":["Hematology"],"u":"/en/post/lymphocytosis/"}]