Blood count and blood group · Blood

Neutrophils

The most numerous white blood cells and the first defense against bacteria; rise with infection, often fall due to medicines.

At a glance

Measured in blood
In 5 test panels
No special preparation

Explanation

Neutrophils: what is measured?

Neutrophils (neutrophil granulocytes) are the most common white blood cells, about half to two thirds of the total. They are made in the bone marrow, live only briefly and are the first cells to go to an infection or damaged tissue to clear bacteria. The laboratory counts them as part of the white blood cell differential (the breakdown of the white blood cells into types).

What can it detect?

Bacterial infections and other acute inflammation
Too few neutrophils (neutropenia), for example as a side effect of medicines or with a bone marrow disorder
Rarely: a blood disease, such as leukemia or another bone marrow disorder

Result

What does the result mean?

Neutrophils too high

A raised neutrophil count (neutrophilia) usually fits a bacterial infection or other acute inflammation, for example after an injury, burn or surgery. Smoking, heavy physical exertion, stress, pregnancy and corticosteroids (anti-inflammatory drugs such as prednisone) also raise the count, without anything being wrong. Symptoms that go with an infection are fever, pain or feeling ill. A strongly raised count with immature cells or other abnormalities in the blood count is rare and can go with a blood disease.

Neutrophils too low

A low neutrophil count (neutropenia) is usually caused by medicines, such as some painkillers, antibiotics, thyroid inhibitors or chemotherapy, or by a viral infection that temporarily lowers the count. People of African or Middle Eastern descent often naturally have a lower count, without their immune defense working less well. A deficiency of vitamin B12 or folic acid and a severe infection can also lower the count. With a strongly low count, roughly below 0.5 x 10⁹ per liter, the risk of serious infections is higher; fever is then an alarm signal that must be assessed quickly.

After an abnormal result

With a slightly abnormal count without symptoms, the GP usually repeats the blood count after a few weeks and reviews medicine use and recent infections. With a persistently or strongly low count, or with other abnormalities in the blood count, referral to the internist (specialist in internal medicine) or hematologist (specialist in blood diseases) follows.

Reliability

How reliable is the test?

The neutrophil count is part of the blood count and on its own is not a test for a particular disease. According to the Dutch Society for Clinical Chemistry (NVKC), a raised count points to an infection or inflammation, but not to its location or cause; a low count is usually due to medicines or a viral infection. The value is assessed together with the total number of white blood cells, CRP and the symptoms, and a slightly abnormal value is preferably repeated.

What can affect the result?

Smoking, exertion, stress, pregnancy and corticosteroids raise the count without infection.
Many medicines and viral infections lower the count temporarily; a single measurement cannot distinguish a temporary shortage from a permanent one.
The reference values are based on people of European descent; in people of African or Middle Eastern descent, a lower count is often normal (benign ethnic neutropenia).
Laboratories differ in reference values and in reporting as a percentage or as an absolute count; the absolute count is the most reliable.

Who it is for

Who is the test useful for?

Useful for

Useful as part of an extended blood count with fever or symptoms that fit an infection or inflammation, with recurring infections, for monitoring during medicines that can suppress the bone marrow (such as chemotherapy, methotrexate or thyroid inhibitors) and with a known blood disease. As a single test, it has little value; routine measurement is not needed in adults without symptoms.

How common is it?

A raised neutrophil count is the most common abnormality in the white blood cell count, because bacterial infections are common. There are no Dutch figures on how often neutropenia is found; a slightly low count due to medicines or a viral infection is fairly common, a severe shortage is rare. Leukemia and other bone marrow disorders are rare and occur mainly at an older age.

NVKC, allesovertesten.nl

Drawbacks and risks

A slightly low count is often normal or temporary, especially in people of African descent; without that context, it can lead to unnecessary worry and testing.
A normal neutrophil count does not rule out an infection.

Get tested

Neutrophils: test panels

Neutrophils is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.

Blood draw
Complete Blood Count (CBC)
Complete Blood Count Extended; standard blood count plus detailed white blood cell analysis.
€ 27,00
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Whoop (Advanced Labs)
Comprehensive blood analysis with biomarkers that integrates directly with your WHOOP wearable for optimal performance and recovery.
€ 385,00
Fingerstick
Full blood count with differential (CBC) (finger-prick)
Full blood count including haemoglobin, platelets and a white cell differential.
€ 27,00

How reliable is the test?

Neutrophils