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B and T Cell Screen

Definition

A B and T cell screen is a laboratory test to determine the amount of T and B cells (lymphocytes) in the blood.

Alternative Names

Direct immunofluorescence; E-rosetting; T and B lymphocyte assays; B and T lymphocyte assays

How the test is performed

Blood is 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.

Blood could also be obtained by capillary sample (fingerstick, or heelstick in infants).

After the blood is drawn it goes through a two-step process. First, the lymphocytes are separated from other blood parts. Once the cells are separated, identifiers are added to distinguish between T and B cells. The E-rosetting test identifies T cells and direct immunofluorescence is used to identify B cells.

How to prepare for the test

Tell your health care provider if you have had any of the following, which might affect your T and B cell count:

  • Chemotherapy
  • Surgery
  • Steroid therapy
  • Stress
  • X-rays
  • Recent infection

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 may order this test if you have signs of certain diseases that weaken the immune system. It may also be used to distinguish between cancerous and noncancerous disease, especially cancers that involve the blood and bone marrow.

The test may also be used to determine how well treatment for certain conditions is working.

Normal Values

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

What abnormal results mean

Abnormal T and B cell counts suggest possible diseases. Further testing is needed to confirm a diagnosis.

An increased T cell count may be due to:

  • Infectious mononucleosis
  • Multiple myeloma
  • Acute lymphoblastic leukemia
  • Chronic lymphocytic leukemia

An increased B cell count may be due to:

  • Chronic lymphocytic leukemia
  • Multiple myeloma
  • Waldenstrom's macroglobulinemia
  • DiGeorge syndrome

A decreased T cell count may be due to:

  • Congenital T-cell deficiency disease
    • Nezelof syndrome
    • DiGeorge syndrome
    • Wiskott-Aldrich syndrome
  • Acquired T-cell deficiency states
    • HIV infection
    • HTLV-1 infection
  • B cell proliferative disorders
    • Acquired immunodeficiency syndrome
    • Chronic lymphocytic leukemia
    • Waldenstrom's macroglobulinemia

A decreased B cell count may be due to:

  • Acute lymphoblastic leukemia
  • Congenital immunoglobulin deficiency disorders
  • Acquired immunoglobulin deficiency disorders

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample 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)

References

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

Review Date: 8/28/2009

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Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Medical Center. Please discuss with your doctor any questions or concerns you may have.