A shift to the left is present when which cells are elevated?

A shift to the left is present when which cells are elevated?

• A. Neutrophils
• B. Bands or Stabs
• C. Lymphocytes
• D. Eosinophils

Answer: (B)

A shift to the left means more immature neutrophils are circulating, signaling the bone marrow is rapidly releasing cells to fight an acute infection or inflammation. The immature form most specifically associated with this shift is the band (stab) neutrophil. When bands are elevated, the differential shows a higher proportion of immature neutrophils relative to mature segmented neutrophils, which is what clinicians refer to as a left shift. So the elevation of bands or stab neutrophils best explains a left shift. Neutrophils in general may be increased during infection, but the hallmark of a left shift is the presence of these immature neutrophils. Lymphocytes tend to rise with viral infections, not left shifts, and eosinophils rise with allergies or parasitic infections, which also doesn’t indicate a left shift.

A shift to the left means more immature neutrophils are circulating, signaling the bone marrow is rapidly releasing cells to fight an acute infection or inflammation. The immature form most specifically associated with this shift is the band (stab) neutrophil. When bands are elevated, the differential shows a higher proportion of immature neutrophils relative to mature segmented neutrophils, which is what clinicians refer to as a left shift.

So the elevation of bands or stab neutrophils best explains a left shift. Neutrophils in general may be increased during infection, but the hallmark of a left shift is the presence of these immature neutrophils. Lymphocytes tend to rise with viral infections, not left shifts, and eosinophils rise with allergies or parasitic infections, which also doesn’t indicate a left shift.