From the Guidelines
The most effective way to test for low lymphocytes is through a complete blood count (CBC) with differential, which measures the levels of different blood cells, including lymphocytes, as recommended by the most recent guidelines 1.
Diagnosis of Low Lymphocytes
To diagnose low lymphocytes, the following tests can be performed:
- A complete blood count (CBC) with differential to measure the levels of different blood cells, including lymphocytes
- Flow cytometry to identify specific lymphocyte subsets (T cells, B cells, and NK cells)
- Additional testing, such as bone marrow examination, HIV testing, and tests for autoimmune disorders, may be necessary to determine the underlying cause of low lymphocytes
Importance of Recent Guidelines
The most recent guidelines, published in 2024 1, emphasize the importance of using a CBC with differential as the primary test for diagnosing low lymphocytes. This is because it provides a comprehensive overview of the different blood cell types, including lymphocytes.
Limitations of Older Guidelines
Older guidelines, such as those published in 1992 1 and 2008 1, may not reflect the current best practices for diagnosing low lymphocytes. Therefore, it is essential to rely on the most recent and highest-quality evidence when making diagnostic decisions.
Clinical Implications
In clinical practice, a CBC with differential should be the first-line test for diagnosing low lymphocytes. This test is widely available, relatively inexpensive, and provides valuable information about the different blood cell types. By following the most recent guidelines and using a CBC with differential as the primary diagnostic test, clinicians can ensure that patients with low lymphocytes receive accurate and timely diagnoses, which is essential for improving morbidity, mortality, and quality of life outcomes.
From the Research
Tests for Low Lymphocytes
- Flow cytometry is a common test used to measure lymphocyte subsets, including CD4 and CD8 T cells, B cells, and natural killer cells 2, 3.
- A 12-color flow cytometry panel can be used to study lymphocyte, monocyte, and dendritic cell subsets in humans, allowing for the identification of multiple cell populations in a single tube 3.
- Complete Blood Count (CBC) can be used to predict CD4 lymphocyte count in HIV patients, using a methodology based on sets theory that takes into account total white blood cell count and lymphocyte count 4.
- Manual percent lymphocytes can be used as an alternative to automated hematology analyzers, which may give higher lymphocyte percentages due to nonrandom cell loss and lymphocyte resolution 5.
- Functional and molecular evaluation of lymphocytes can be performed using a range of tests, including screening tests and more complex in vitro testing, such as mutation analysis 6.