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Left shift or blood shift is an increase in the number of immature cell types among the blood cells in a sample of blood. Many (perhaps most) clinical mentions of left shift refer to the white blood cell lineage, particularly neutrophil -precursor band cells , [ 1 ] : 84–84 thus signifying bandemia .
A "left shift" refers to the presence of increased proportions of younger, less well differentiated neutrophils and neutrophil-precursor cells in the blood. This generally reflects early or premature release of myeloid cells from the bone marrow , the site where neutrophils are generated.
Neutrophilia and left shift (the presence of immature neutrophil precursors such as band neutrophils and metamyelocytes in the peripheral blood) often accompany toxic changes, as these phenomena also occur in response to inflammation. [1] [5]
The Arneth count determines the percentage of neutrophils with one, two, three, four, and five or more lobes. [ citation needed ] Individuals who have a larger percentage of neutrophils with fewer lobes have a left shift which can be indicative of disease processes such as infection , malignant tumors, hemolytic crises, myocardial infarction ...
While many clinicians refer to the presence of neutrophilia as a "left shift", this is imprecise, as a left shift indicates the presence of immature neutrophil forms, [citation needed] but neutrophilia refers to the entire mass of neutrophils, both mature and immature. Neutrophilia can be indicative of:
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Leukocytosis can be subcategorized by the type of white blood cell that is increased in number. Leukocytosis in which neutrophils are elevated is neutrophilia; leukocytosis in which lymphocyte count is elevated is lymphocytosis; leukocytosis in which monocyte count is elevated is monocytosis; and leukocytosis in which eosinophil count is elevated is eosinophilia.
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