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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
A blood sample is needed. For information on how this is done, see: Venipuncture
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
- HIV
- Radiation therapy
- Recent or current infection
- Steroid therapy
- Stress
- Surgery
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 Results
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
Abnormal T and B cell counts suggest a possible disease. Further testing is needed to confirm a diagnosis.
An increased T cell count may be due to:
- Acute lymphoblastic leukemia
- Chronic lymphocytic leukemia
- Infectious mononucleosis
- Multiple myeloma
- Syphilis
- Toxoplasmosis
- Tuberculosis
An increased B cell count may be due to:
- Chronic lymphocytic leukemia
- DiGeorge syndrome
- Multiple myeloma
- Waldenstrom's macroglobulinemia
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
- Chronic lymphocytic leukemia
- Waldenstrom's macroglobulinemia
A decreased B cell count may be due to:
- Acquired immunodeficiency syndrome
- Acute lymphoblastic leukemia
- Congenital immunoglobulin deficiency disorders
- Acquired immunoglobulin deficiency disorders
Risks
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
Marks PW, Rosenthal DS. Hematologic manifestations of systemic disease: infection, chronic inflammation, and cancer. 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 157.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
