How the Test is Performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The blood sample is sent to a laboratory. A WBC count is almost always done as part of a complete blood count (CBC).

How to Prepare for the Test

No special preparation is usually needed. Tell your doctor about any medications you are taking, including over-the-counter products. Certain drugs may interfere with test results.

Drugs that may increase WBC counts include:

• Allopurinol
• Aspirin
• Chloroform
• Corticosteroids
• Epinephrine
• Heparin
• Quinine
• Triamterene

Drugs that may lower your WBC count include:

• Antibiotics
• Anticonvulsants
• Antihistamines
• Antithyroid drugs
• Arsenicals
• Barbiturates
• Chemotherapy drugs
• Diuretics
• Sulfonamides

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

Your doctor will order this test to find out how many white blood cells you have. Your body produces more white blood cells when you have an infection or allergic reaction -- even when you are under general stress.

Normal Results

4,500-10,000 white blood cells per microliter (mcL).

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

A low number of WBCs is called leukopenia. It may be due to:

• Bone marrow deficiency or failure (for example, due to infection, tumor, or abnormal scarring)
• Collagen-vascular diseases (such as systemic lupus erythematosus)
• Disease of the liver or spleen
• Radiation therapy or exposure

A high number of WBCs is called leukocytosis. It may be due to:

• Anemia
• Bone marrow tumors
• Infectious diseases
• Inflammatory disease (such as rheumatoid arthritis or allergy)
• Leukemia
• Severe emotional or physical stress
• Tissue damage (for example, burns)

These lists are not all inclusive.

Risks

There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Considerations

People who have had their spleen removed (splenectomy) will always have a slightly higher number of WBCs.

Alternative Names

Leukocyte count; White blood cell count

References

Bagby GC. Leukopenia and leukocytosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 173.

Dinauer MC, Coates TD. Disorders of phagocyte function and number. In: Hoffman R, Benz EJ Jr, Shattil SJ, et al, eds. Hoffman Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 50.

Update Date: 2/13/2012

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.