Immature Grans (Abs)

Optimal Result: 0 - 0.1 x10E3/µL.

Immature granulocytes are white blood cells that are immature. Small amounts of white blood cells may be present on a complete blood count test whether or not you have an infection although healthy people do not show immature granulocytes on their blood test report.

However, whenever your body is fighting an infection, it will increase its white blood cell count, and more of the white blood cells will be immature. 

Immature granulocyte counts are often tests ordered for patients that are highly susceptible to develop infections. They may already have a suppressed immune system. 

When this test is run, if the result shows an increase, it means that the immune response will be severe. Thus, it’s an important test for patients receiving chemotherapy, diagnosed with HIV/AIDS, or ones in the ICU in the hospital. 

Normal Ranges for Immature Granulocytes:

Neutrophils – 40–80% (2.0–7.0×10 9 /l)

Lymphocytes – 20–40% (1.0–3.0×10 9 /l)

Monocytes – 2–10% (0.2–1.0×10 9 /l)

Eosinophils – 1–6% (0.02–0.5×10 9 /l)

Basophils – < 1–2% (0.02–0.1×10 9 /l)

More than 2% immature granulocytes is a high count.

Sources:

https://www.sysmex-europe.com/academy/knowledge-centre/sysmex-parameters/immature-granulocyte-ig-count.html

- https://www.healthyandnaturalworld.com/immature-granulocytes/

What does it mean if your Immature Grans (Abs) result is too low?

There is no health issue associated with low granulocyte counts.

What does it mean if your Immature Grans (Abs) result is too high?

- Measurement of immature granulocytes (IG) percentage may be used as a marker of bacterial infections. 

- Immature granulocytes (IG) level in peripheral blood is used as an early sign of infection. 

- IG could also be elevated in other conditions like inflammatory or cancerous diseases and in pregnancy.

- Immature granulocytes can be elevated in inflammatory disease

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With the exception of blood from neonates or pregnant women, the appearance of immature granulocytes in the peripheral blood indicates an early-stage response to infection, inflammation or other stimuli of the bone marrow. The presence of immature granulocytes (IG) in the peripheral blood provides important information indicating enhanced bone marrow activity. Evaluation of the IG count is therefore a promising option in sepsis.

Immature granulocytes are usually not detected in healthy individuals but are elevated in patients with: 

- bacterial infections, 

- acute inflammatory disorders, 

- cancer (marrow metastasis), 

- tissue necrosis, 

- acute transplant rejection, 

- surgical and orthopedic trauma, 

- myeloproliferative neoplasm, 

- steroid use, 

- and pregnancy. 

Usually an increase in Immature granulocytes is accompanied by an increase in the absolute neutrophil count. However, elderly patients, neonates, and patients with myelosuppression may have elevated Immature granulocytes without an elevation of the neutrophil count.

Limitations:

The immature granulocytes count alone does not let you predict sepsis (= when your body has an unusually severe response to an infection) or infection. However, it can support diagnosis and prediction together with other parameters such as cytokines, interleukins and CRP. It is more useful as a monitoring parameter when the patient has already been diagnosed correctly and is under treatment.

As a marker for children:

The immature granulocytes count of children, especially premature neonates or neonates younger than seven days, has to be taken with care due to their immature immune systems and the greater number of immature cells in the circulating blood.

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