Neu in a blood test – what is it

Nowadays, all routine tests in the laboratory – and general blood tests refer specifically to these studies – are performed by special laboratory technology, which includes hematological analyzers. Therefore, the modern blood test result is a bit like a cashier’s check, which is printed on thermal paper, and it contains symbols that were unfamiliar to doctors 20 years ago. So, everyone knew what a KLA, or a complete blood count, was. But what the Neu blood test means, and what this study is talking about, was completely impossible to understand.

In our time, this designation refers to leukocytes, to the largest of their subpopulations. What is Neu? What does such a blood test reveal? What are the normal values ​​for this value when this study is applied, and is it performed separately?

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Neu in a blood test – what is it?

Neu are neutrophils in the blood. Translated from Latin, it simply means “lovers of neutral”. What is this about? Taxonomically, the place of neutrophils is as follows:

  • in a person’s blood there is a liquid part, or blood plasma, and there are also cellular elements – these are red blood cells, or erythrocytes, white blood cells – leukocytes, and platelets, or platelets, which are responsible for blood clotting,
  • Among white blood cells, or leukocytes, there are several varieties: containing granules in the nuclei of cells, and not containing such granules. Here, the representatives of the first class include neutrophils in a blood test.

Since neutrophils contain special inclusions in their nuclei, they are referred to as granulocytes. And these granules can be colored in different tones if a fixed blood preparation is prepared. In the event that a blood product is not stained, but a so-called native smear is done, then in this smear it is impossible to distinguish neutrophils, and to distinguish them from other leukocytes.

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Why is this happening? Because the granules are colored differently with chemical dyes. If the dye has an acidic property, then it stains the granulocytes with acidophilic granules, which attract this acidic dye to themselves. This type of granulocyte is called eosinophils because eosin is a pink acidic dye.

In the event that a leukocyte is stained with a basic, alkaline dye, then it is called a basophilic leukocyte, and its nucleus turns out to be blue. In the same case, if a granulocyte takes a neutral dye, it is called a neutrophil. Now it is clear why these blood cells were given such a name: “loving neutrality”

Neutrophils in the blood receive their granules when they are born, and in mature cells these granules are no longer formed. Under the microscope, the neutrophil looks like a cell with nuclear granularity, ranging from red-violet to brown. At the same time, their cytoplasm is colored pink.

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It should be recalled that there are also monocytes and lymphocytes, which also belong to leukocytes, and do not have any granules at all: their function is completely different. A brisk movement is very characteristic of neutrophils. They are not only carried away by the blood flow in capillaries and larger vessels, they are able to move and form pseudopodia, like amoebas. They are able to actively detect and grasp various foreign particles, as well as various microorganisms, absorb and destroy them. When a boil is opened, a huge number of dead neutrophils “died in a fight” form just an accumulation of pus. They strive from all sides to the focus of inflammation, attracted by biologically active substances, in order to cleanse the infected area from microorganisms.

What are formula shift and cellular rejuvenation?

Before talking about the reasons for the deviation from the norm in the number of neutrophils, you need to talk about what the “shift in the leukocyte formula” means. It was said above that when there is an inflammatory process, there are many neutrophils, and doctors can reasonably judge from this fact about the presence of an infectious disease. But in addition to increasing the number of neutrophils, they “rejuvenate”, the number of stab cells increases, metamyelocytes appear, or young ones.

This phenomenon is called a “shift of the leukocyte formula to the left”, and can indicate the following conditions:

  • malignant tumors at the stage of metastatic lesion,
  • the onset of hematological disease of chronic myeloid leukemia,
  • decompensated metabolic acidosis associated with blood acidification and metabolic coma, for example, diabetic, ketoacidotic, thyrotoxic crisis,
  • with severe physical stress,
  • with rapidly ongoing infectious diseases.

In addition, in some cases, such a significant rejuvenation of the cellular composition of neutrophils may indicate the onset of acute leukemia.

As for the “shift to the right”, this is the phenomenon of the disappearance of stab-nucleated young cells, and an increase in the number of segmented neutrophils – the “aging” of the population. This may indicate bone marrow depletion, chronic hepatic and renal failure, as well as a recent massive blood transfusion, in which all young forms have not yet entered the bloodstream, but are in the bone marrow.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.