WBC count

• Alternative Names

  Leukocyte count; White blood cell count

• How the test is performed

  Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

  Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

  Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

  In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

  The blood sample is sent to a laboratory. A WBC count is almost always done as part of a complete blood count (CBC).

• How to prepare for the test

  No special preparation is usually needed. Tell your doctor about any medications you are taking, including over-the-counter products. Certain drugs may interfere with test results.

  Drugs that may increase WBC counts include:

  • Allopurinol
  • Aspirin
  • Chloroform
  • Corticosteroids
  • Epinephrine
  • Heparin
  • Quinine
  • Triamterene

  Drugs that may lower your WBC count include:

  • Antibiotics
  • Anticonvulsants
  • Antihistamines
  • Antithyroid drugs
  • Arsenicals
  • Barbiturates
  • Chemotherapy drugs
  • Diuretics
  • Sulfonamides
• How the test will feel

  When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

• Why the test is performed

  Your doctor will order this test to find out how many white blood cells you have. Your body produces more white blood cells when you have an infection or allergic reaction -- even when you are under general stress.

• Normal Values

  4,500-10,000 white blood cells per microliter (mcL).

  Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

• What abnormal results mean

  A low number of WBCs is called leukopenia. It may be due to:

  • Bone marrow failure (for example, due to infection, tumor, or abnormal scarring)
  • Collagen-vascular diseases (such as lupus erythematosus)
  • Disease of the liver or spleen
  • Radiation therapy or exposure

  A high number of WBCs is called leukocytosis. It may be due to:

  • Anemia
  • Infectious diseases
  • Inflammatory disease (such as rheumatoid arthritis or allergy)
  • Leukemia
  • Severe emotional or physical stress
  • Tissue damage (for example, burns)

  These lists are not all inclusive.

• What the risks are

  There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

  Other risks associated with having blood drawn are slight but may include:

  • Excessive bleeding
  • Fainting or feeling light-headed
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)
• Special considerations

  People who have had their spleen removed (splenectomy) will always have a slightly higher number of WBCs.

• References

  Bagby GC. Leukopenia and leukocytosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 173.

Review Date: 2/21/2009

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.