Test Findings
 

Left Shift of Neutrophils

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Left Shift of Granulocytes

  • Left shift refers to increased numbers of circulating neutrophil precursors (band forms, metamyelocytes, myelocytes, promyelocytes or even blasts).
  • This may be physiologic in response to a stress on the body such as pregnancy, infection or inflammation; it may occur with administration of granulocyte colony stimulating factor (G-CSF); or it may be a sign of bone marrow infiltration.
    • Causes of Left Shift of Granulocytes

    • Pregnancy
    • Infection / inflammation
    • G-CSF administration
    • Bone marrow infiltration - MPNS, leukaemias, lymphomas, myeloma, metastatic cancer
  • The presence of nucleated red blood cells and left shift is referred to as a leukoerythroblastic blood film. If left shift is present then look for nucleated red cells.
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