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White blood cells 
 Definition: 
 White blood cells or leukocytes are cells of the immune system which 
defend the body against both infectous disease and foreign materials. 
 Characters of WBCs: 
1. Whenever a germ or infection enters the body the white blood 
cells have a variety of ways by which they can attack. Some will 
produce protective antibodies that will overpower the germ. Others 
will surround and devour the bacteria. 
2. The white blood cells have a rather short life cycle, living from a 
few days to a few weeks. 
3. Several different and diverse types of leukocytes exist, but they 
are all produced and derived from a multipotent cell in the bone 
marrow known as a hematopoietic stem cell. 
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Characters of WBCs 
4. Leukocytes are found throughout the body, 
including the blood and lymphatic system. 
5. The name "White Blood Cell" derives from the 
fact that after cenrifugation of a blood sample, 
the white cells are found in the Buffy coat, a 
thin layer of nucleated cells between the 
sedimented red blood cells and the blood 
plasma, which is typically white in color. The 
scientific term leukocyte directly reflects this 
description, derived from Greek leuko - white, 
and cyte - cell. Brought to you by
(White cell count (WBC 
 White cell count (WBC) is the total number of leukocytes in a 
volume of blood, expressed as thousands/μl. 
 As with the RBC, the WBC can be done by manual methods 
or by automated cell counters. 
 Normal Values: 
• Newborn 9.0-30.0 x 103/μl 
• 1 week 5.0-21.0 x 103/μl 
• 1 month 5.0-19.5 x 103/μl 
• 6-12 months 6.0-17.5 x 103/μl 
• 2 years 6.2-17.0 x 103/μl 
• Child/adult 4.8-10.8 x 103/μl 
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Leukocytosis 
 Leukocytosis is a condition characterized by an 
elevated number of white cells in the blood, 
which is usually due to: 
 Bacterial infection such as appendicitis, tonsillitis, ulcers 
and urinary tract infection 
 Leukemia. 
 Pregnancy. 
 Hemolytic disease of new born. 
 Following exercise. 
 Emotional stress. 
 Food intake. Brought to you by
Leukopenia 
 Leukopenia is a condition characterized by a 
decreased number of white cells in the blood, which 
is usually due to: 
 Viral disease such as measles and infectious hepatitis. 
 Some bacterial infections such as typhoid fever, 
brucellosis, and typhus fever. 
 Rheumatoid arthritis. 
 Systemic Lupus Erythematosis. 
 Certain drugs such as radio therapy and chemotherapy. 
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Principle of WBCs count test 
 Free-flowing capillary or well-mixed anticoagulated 
venous blood is added to a diluent) at a specific 
volume in the thoma pipette. 
 The diluent lyses the erythrocytes but preserves 
leukocytes and platelets. 
 The diluted blood is added to the hemacytometer 
chamber. 
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 Specimen: 
 EDTA- anticoagulated blood or capillary blood is 
preferred. 
 Reagents, supplies and equipment: 
 White blood cells count diluting fluid which may be one 
of the following: 
 Acetic acid 2% (v/v) in distilled water. 
 HCL 1% (v/v) in distilled water. 
 Turks' solution which is formed of: 
 Glacial acetic acid 3 ml 
 Crystal violet 1 ml 
 100 ml distilled water. 
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Equipment 
1. White blood cells count 
diluting fluid 
2. Thoma white pipette 
3. Hemacytometer and coverslip 
4. Microscope 
5. Lint-free wipe 
6. Alcohol pads 
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haemocytometer chamber 
Thoma white pipette 
Rubber sucking tube 
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Hemacytometer 
 The hemacytometer counting chamber is used 
for cell counting. 
 It is constructed so that the distance between 
the bottom of the coverslip and the surface of 
the counting area of the chamber is 0.1 mm. 
 The surface of the chamber contains two square 
ruled areas separated by an H-shaped moat. 
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Hemacytometer 
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Procedure 
1. Draw the blood up to 0.5 mark in the thoma pipette. 
2. Wipe the outside of the capillary pipette to remove 
excess blood that would interfere with the dilution 
factor. 
3. Holding the pipette almost vertical place into the fluid. 
Draw the diluting fluid into the pipette slowly until the 
mixture reaches the 11 mark, while gently rotating the 
pipette to ensure a proper amount of mixing. 
4. Place the pipette in a horizontal position and firmly 
hold the index finger of either hand over the opening in 
the tip of the pipette, detach the aspirator from the 
other end of the pipette now the dilution of the blood is 
completed 
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Procedure 
5. Mix the sample for at least 3 minutes to facilitate 
hemolysis of RBCs. 
6. Clean the hemacytometer and its coverslip with an 
alcohol pad and then dry with a wipe. 
7. Before filling the chamber, discard the first four to 
five drops of the mixture on apiece of gauze to expel 
the diluent from the stem. 
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Procedure 
8. Carefully charge hemacytometer with 
diluted blood by gently squeezing sides of 
reservoir to expel contents until chamber is 
properly filled. 
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Procedure for counting WBC’s 
1. Under 10 x magnifications, scan to ensure even 
distribution. Leukocytes are counted in all nine large 
squares of counting chamber. 
2. Count cells starting in the upper left large corner 
square. Move to the upper right corner square, 
bottom right corner square, bottom left corner square 
and end in the middle square. 
3. Count all cells that touch any of the upper and left 
lines, do not count any cell that touches a lower or 
right line. 
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Calculations 
 Depth= 0.1 
 Correction for dilution: 
 The thoma pipette is 1:20 
 Dilution factor 20 
 Correction of volume: 
 Volume of 1small square = 1x1x0.1= 0.1mm3 
 Volume of 4 large squares = 4x0.1= 0.4 mm3 or μL 
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 Suppose that you count 50 cells in 4 squares 
(0.4mm3), found the count in 1mm3? 
 50 o.4 mm3 
 X 1mm3 
 X = 50 x 1 0.4 
• Volume correction = 1 0.4 
Total count  1mm3 = 
 No. of cells x volume correction x dilution = 
 no. of cells x ( 10.4 ) x 20 = 
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Discussion 
1. A highly elevated leukocyte count (leukocytosis) may make 
accurate counting difficult. In either instance, a secondary 
dilution should be made. When calculating the total count, 
adjust the formula to allow for secondary dilution. Or a red 
pipette can be used to make 1:100 dilution. 
2. If count is less than 3000 cell/mm3, a smaller dilution of 
blood should be used to ensure a more accurate count. 
This can be accomplished by drawing the blood up to 1.0 
mark and the diluting fluid to the 11 mark. The dilution will 
then be 1 : 10, and the dilution factor in the calculation will 
be 10 
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Discussion 
3. If more than 5 nucleated RBC’s are seen on 
the differential, the total leukocyte count 
should be corrected using the following 
calculation: 
Corrected WBC = 
(Uncorrected leukocyte count x 100) 
(100 + # of NRBC’s/100 WBC’s on differential) 
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White blood cells

  • 2. White blood cells  Definition:  White blood cells or leukocytes are cells of the immune system which defend the body against both infectous disease and foreign materials.  Characters of WBCs: 1. Whenever a germ or infection enters the body the white blood cells have a variety of ways by which they can attack. Some will produce protective antibodies that will overpower the germ. Others will surround and devour the bacteria. 2. The white blood cells have a rather short life cycle, living from a few days to a few weeks. 3. Several different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a hematopoietic stem cell. Brought to you by
  • 3. Characters of WBCs 4. Leukocytes are found throughout the body, including the blood and lymphatic system. 5. The name "White Blood Cell" derives from the fact that after cenrifugation of a blood sample, the white cells are found in the Buffy coat, a thin layer of nucleated cells between the sedimented red blood cells and the blood plasma, which is typically white in color. The scientific term leukocyte directly reflects this description, derived from Greek leuko - white, and cyte - cell. Brought to you by
  • 4. (White cell count (WBC  White cell count (WBC) is the total number of leukocytes in a volume of blood, expressed as thousands/μl.  As with the RBC, the WBC can be done by manual methods or by automated cell counters.  Normal Values: • Newborn 9.0-30.0 x 103/μl • 1 week 5.0-21.0 x 103/μl • 1 month 5.0-19.5 x 103/μl • 6-12 months 6.0-17.5 x 103/μl • 2 years 6.2-17.0 x 103/μl • Child/adult 4.8-10.8 x 103/μl Brought to you by
  • 5. Leukocytosis  Leukocytosis is a condition characterized by an elevated number of white cells in the blood, which is usually due to:  Bacterial infection such as appendicitis, tonsillitis, ulcers and urinary tract infection  Leukemia.  Pregnancy.  Hemolytic disease of new born.  Following exercise.  Emotional stress.  Food intake. Brought to you by
  • 6. Leukopenia  Leukopenia is a condition characterized by a decreased number of white cells in the blood, which is usually due to:  Viral disease such as measles and infectious hepatitis.  Some bacterial infections such as typhoid fever, brucellosis, and typhus fever.  Rheumatoid arthritis.  Systemic Lupus Erythematosis.  Certain drugs such as radio therapy and chemotherapy. Brought to you by
  • 7. Principle of WBCs count test  Free-flowing capillary or well-mixed anticoagulated venous blood is added to a diluent) at a specific volume in the thoma pipette.  The diluent lyses the erythrocytes but preserves leukocytes and platelets.  The diluted blood is added to the hemacytometer chamber. Brought to you by
  • 8.  Specimen:  EDTA- anticoagulated blood or capillary blood is preferred.  Reagents, supplies and equipment:  White blood cells count diluting fluid which may be one of the following:  Acetic acid 2% (v/v) in distilled water.  HCL 1% (v/v) in distilled water.  Turks' solution which is formed of:  Glacial acetic acid 3 ml  Crystal violet 1 ml  100 ml distilled water. Brought to you by
  • 9. Equipment 1. White blood cells count diluting fluid 2. Thoma white pipette 3. Hemacytometer and coverslip 4. Microscope 5. Lint-free wipe 6. Alcohol pads Brought to you by
  • 10. haemocytometer chamber Thoma white pipette Rubber sucking tube Brought to you by
  • 11. Hemacytometer  The hemacytometer counting chamber is used for cell counting.  It is constructed so that the distance between the bottom of the coverslip and the surface of the counting area of the chamber is 0.1 mm.  The surface of the chamber contains two square ruled areas separated by an H-shaped moat. Brought to you by
  • 13. Procedure 1. Draw the blood up to 0.5 mark in the thoma pipette. 2. Wipe the outside of the capillary pipette to remove excess blood that would interfere with the dilution factor. 3. Holding the pipette almost vertical place into the fluid. Draw the diluting fluid into the pipette slowly until the mixture reaches the 11 mark, while gently rotating the pipette to ensure a proper amount of mixing. 4. Place the pipette in a horizontal position and firmly hold the index finger of either hand over the opening in the tip of the pipette, detach the aspirator from the other end of the pipette now the dilution of the blood is completed Brought to you by
  • 14. Procedure 5. Mix the sample for at least 3 minutes to facilitate hemolysis of RBCs. 6. Clean the hemacytometer and its coverslip with an alcohol pad and then dry with a wipe. 7. Before filling the chamber, discard the first four to five drops of the mixture on apiece of gauze to expel the diluent from the stem. Brought to you by
  • 15. Procedure 8. Carefully charge hemacytometer with diluted blood by gently squeezing sides of reservoir to expel contents until chamber is properly filled. Brought to you by
  • 16. Procedure for counting WBC’s 1. Under 10 x magnifications, scan to ensure even distribution. Leukocytes are counted in all nine large squares of counting chamber. 2. Count cells starting in the upper left large corner square. Move to the upper right corner square, bottom right corner square, bottom left corner square and end in the middle square. 3. Count all cells that touch any of the upper and left lines, do not count any cell that touches a lower or right line. Brought to you by
  • 18. Calculations  Depth= 0.1  Correction for dilution:  The thoma pipette is 1:20  Dilution factor 20  Correction of volume:  Volume of 1small square = 1x1x0.1= 0.1mm3  Volume of 4 large squares = 4x0.1= 0.4 mm3 or μL Brought to you by
  • 19.  Suppose that you count 50 cells in 4 squares (0.4mm3), found the count in 1mm3?  50 o.4 mm3  X 1mm3  X = 50 x 1 0.4 • Volume correction = 1 0.4 Total count 1mm3 =  No. of cells x volume correction x dilution =  no. of cells x ( 10.4 ) x 20 = Brought to you by
  • 20. Discussion 1. A highly elevated leukocyte count (leukocytosis) may make accurate counting difficult. In either instance, a secondary dilution should be made. When calculating the total count, adjust the formula to allow for secondary dilution. Or a red pipette can be used to make 1:100 dilution. 2. If count is less than 3000 cell/mm3, a smaller dilution of blood should be used to ensure a more accurate count. This can be accomplished by drawing the blood up to 1.0 mark and the diluting fluid to the 11 mark. The dilution will then be 1 : 10, and the dilution factor in the calculation will be 10 Brought to you by
  • 21. Discussion 3. If more than 5 nucleated RBC’s are seen on the differential, the total leukocyte count should be corrected using the following calculation: Corrected WBC = (Uncorrected leukocyte count x 100) (100 + # of NRBC’s/100 WBC’s on differential) Brought to you by
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