White Blood Cell Differential Test

Atypical Lymphocytes

Optimal Result: 0 - 1 %.

Atypical lymphocytes are lymphocytes that have been activated to respond to a viral infection (occasionally a bacterial or parasitic infection). These cells are characterized by their increased size and often the presence of active protein synthesis. Pathologically altered lymphocytes are associated with numerous diseases. 

A few atypical lymphocytes are probably of little clinical significance. A large number of atypical lymphocytes are often found in viral infections like mononucleosis, cytomegalovirus infections and hepatitis B. Toxoplasmosis, certain bacterial infections, medications, stress and autoimmune diseases can also be accompanied by a larger number of atypical lymphocytes.

Atypical lymphocytes can also be observed in patients with several viral infections, such as Epstein-Barr virus infection, cytomegalovirus infection, rubella, Hantavirus infection, viral hepatitis and HIV infection.

Several studies have shown that atypical lymphocytes have also been found in the peripheral blood and bronchoalveolar lavage (BAL) samples of COVID-19 patients. It may reflect the disease pathophysiology and provide important information about the diagnosis or prognosis of the disease.

References:

Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw-Hill Professional; 2008. [Google Scholar]

Chong VCL, Lim KGE, Fan BE, Chan SSW, Ong KH, Kuperan P. Reactive lymphocytes in patients with COVID-19. Br J Haematol. 2020;189(5):844. doi: 10.1111/bjh.16690 [PubMed]

El Jamal SM, Salib C, Stock A, Uriarte-Haparnas NI, Glicksberg BS, Teruya-Feldstein J, et al. Atypical lymphocyte morphology in SARS-CoV-2 infection. Pathol Res Pract. 2020;216(9):153063. doi: 10.1016/j.prp.2020.153063 [PubMed]

Weinberg SE, Behdad A, Ji P. Atypical lymphocytes in peripheral blood of patients with COVID-19. Br J Haematol. 2020;190(1):36–39. doi: 10.1111/bjh.16848 [PubMed]

Gelarden I, Nguyen J, Gao J, Chen Q, Morales-Nebreda L, Wunderink R, et al. Comprehensive evaluation of bronchoalveolar lavage from patients with severe COVID-19 and correlation with clinical outcomes. Hum Pathol. 2021;113:92–103. doi: 10.1016/j.humpath.2021.04.010 [PubMed]

The atypical lymphocyte, Wood, Turner A. et al., The American Journal of Medicine, Volume 42, Issue 6, 923 - 936 [L]

What does it mean if your Atypical Lymphocytes result is too high?

Atypical lymphocytes have been observed in the peripheral blood of patients in a large number of clinical situations, including:

- immune reactions to transplantation and immunization,

- collagen diseases and other autoimmune disorders,

- malignant disease,

- drug reactions,

- infectious mononucleosis

A large number of atypical lymphocytes are often found in viral infections like mononucleosis, cytomegalovirus infections and hepatitis B. Toxoplasmosis, certain bacterial infections, medications, stress and autoimmune diseases can also be accompanied by a larger number of atypical lymphocytes.

Atypical lymphocytes can also be observed in patients with several viral infections, such as Epstein-Barr virus infection, cytomegalovirus infection, rubella, Hantavirus infection, viral hepatitis and HIV infection.

Several studies have shown that atypical lymphocytes have also been found in the peripheral blood and bronchoalveolar lavage (BAL) samples of COVID-19 patients. It may reflect the disease pathophysiology and provide important information about the diagnosis or prognosis of the disease.

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