Diagnostic Decision: The Complete Blood Count and Leukocyte Differential Count: An Approach to Their Rational Application

150 febrile patients included children (50), adult (50) and neonates (50) from outpatient departments and inpatients of private clinics and hospitals. Patients presented with fever and chills for more than 1 day to 3 days, throat infection, ear infection and cold and fever and only fever as the principal symptoms. After clinical examination all the patients were prescribed for Complete Blood Count (CBC) with differential count(DC) and C-reactive protein(CRP) tests, and in children below 14 years anti-Streptolysin O(ASO) tests ( 75) were prescribed. Patients treated with antibiotics previously two weeks before the study period were not included. Qualitative and quantitative tests were performed on all patients’ samples included in the study depending on the need/prescription by the physician or paediatrician. CBC, neutrophil count and CRP have been very useful indicators and significant in the diagnosis and treatment as well as follow-up of the febrile condition of the patients specially in patients suffering with bacterial infections. Even in patients with Dengue and malaria it gives a fair idea if there were leucocytosis or leukopenia, neutrophilia or neutropenia, thrombocytosis or thrombocytopenia. CBC: Complete blood count, DC: Differential count; MP: malarial parasite, CRP: C-reactive protein, ASO: Anti-Streptolysin O.

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A Novel Automated Slide-Based Technology for Visualization, Counting, and Characterization of the Formed Elements of Blood: A Proof of Concept Study

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2016-0633-oa ◽

2017 ◽

Vol 141 (8) ◽

pp. 1107-1112 ◽

Cited By ~ 5

Author(s):

James W. Winkelman ◽

Milenko J. Tanasijevic ◽

David J. Zahniser

Keyword(s):

Image Analysis ◽

Blood Cell ◽

White Blood Cell ◽

Blood Count ◽

Complete Blood Count ◽

Differential Count ◽

Preparation Technique ◽

Proof Of Concept ◽

New Instrument ◽

Prototype Instrument

Context.— A novel automated slide-based approach to the complete blood count and white blood cell differential count is introduced. Objective.— To present proof of concept for an image-based approach to complete blood count, based on a new slide preparation technique. A preliminary data comparison with the current flow-based technology is shown. Design.— A prototype instrument uses a proprietary method and technology to deposit a precise volume of undiluted peripheral whole blood in a monolayer onto a glass microscope slide so that every cell can be distinguished, counted, and imaged. The slide is stained, and then multispectral image analysis is used to measure the complete blood count parameters. Images from a 600-cell white blood cell differential count, as well as 5000 red blood cells and a variable number of platelets, that are present in 600 high-power fields are made available for a technologist to view on a computer screen. An initial comparison of the basic complete blood count parameters was performed, comparing 1857 specimens on both the new instrument and a flow-based hematology analyzer. Results.— Excellent correlations were obtained between the prototype instrument and a flow-based system. The primary parameters of white blood cell, red blood cell, and platelet counts resulted in correlation coefficients (r) of 0.99, 0.99, and 0.98, respectively. Other indices included hemoglobin (r = 0.99), hematocrit (r = 0.99), mean cellular volume (r = 0.90), mean corpuscular hemoglobin (r = 0.97), and mean platelet volume (r = 0.87). For the automated white blood cell differential counts, r values were calculated for neutrophils (r = 0.98), lymphocytes (r = 0.97), monocytes (r = 0.76), eosinophils (r = 0.96), and basophils (r = 0.63). Conclusions.— Quantitative results for components of the complete blood count and automated white blood cell differential count can be developed by image analysis of a monolayer preparation of a known volume of peripheral blood.

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Common Change of Complete Blood Count Parameters in COVID-19: a Literature Review

Journal Of Medicine & Health ◽

10.28932/jmh.v3i2.3097 ◽

2021 ◽

Vol 3 (2) ◽

Author(s):

Kevin S Dhinata

Keyword(s):

Blood Cell ◽

Healthcare Workers ◽

Blood Count ◽

Complete Blood Count ◽

Differential Count ◽

Distribution Width ◽

Healthcare Facilities ◽

Testing Method ◽

Drastic Increase ◽

The Common

The rising number of COVID-19 all around the world caused a drastic increase in theoccupancy rate of healthcare facilities, triggering overload in some places. This situationrequires healthcare workers to evaluate patients’ conditions and conduct risk stratificationefficiently, especially in a triage situation. Complete blood count is a widely available,economically affordable, and time-efficient testing method which may be significant in assistingthose processes. This review article analyzes changes in complete blood count parameters inCOVID-19 with the aim to identify the common changes in the parameters in COVID-19 patientsand their relation to the disease progression and severity. COVID-19 patients commonlyexperienced anemia, increased red blood cell distribution width, decreased white blood cellcount, significant changes in white blood cell differential count, and thrombocytopenia. It isunderstood that changes in complete blood count parameters and their extent may providevaluable information about the disease severity and prognosis. In conclusion, COVID-19 patientsshare a common pattern of complete blood count parameters alterations which is related to thedisease progression, severity and prognosis. It is expected that complete blood count examinationmay play a major role in COVID-19 management, given the valuable information provided bythe examination.Keywords: complete blood count; COVID-19; erythrocyte; leukocyte; platelet

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Volume, conductance, and scatter parameters of neoplastic and nonneoplastic lymphocytes using Coulter LH780

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_65_17 ◽

2018 ◽

Vol 10 (01) ◽

pp. 085-088

Author(s):

Chidambharam Choccalingam

Keyword(s):

Blood Count ◽

Complete Blood Count ◽

Lymphoblastic Leukemia ◽

Viral Disease ◽

Lymphocytic Leukemia ◽

Differential Count ◽

Blood Cell Count ◽

Differential White Blood Cell ◽

The Right ◽

Hematology Analyzers

Abstract PURPOSE: Automated hematology analyzers yield a complete hematological profile including a complete blood count and a differential white blood cell count. The differential count is based on analyses of three parameters, namely, volume, conductance, and scatter (VCS). We aimed to evaluate the VCS parameters, histograms, and scatterplots of neoplastic and nonneoplastic lymphocytes. MATERIAL AND METHODS: Patients were grouped into four categories, namely, acute lymphoblastic leukemia (ALL), chronic systemic disorders, chronic lymphocytic leukemia (CLL), and acute viral disease. Lymphocytes from all four groups were compared with lymphocytes from normal participants. RESULTS AND CONCLUSIONS: The histogram for acute viral disease showed a trough at T1, which was slightly obliterated, and the F1 curve mildly extended to the right. The T1 for ALL was replaced with a peak at >40% of the preset limit. The F1 peak was shifted to left for CLL. The scatterplot for viral disease showed lymphocytes extending to the variant lymphocyte window. The lymphocytes of ALL extended to the blast window, with both increase in volume and mild increase in scatter. The lymphocytes in CLL were smaller and located below the normal lymphocyte region. Mean lymphocyte volume was significantly increased in ALL and was significantly decreased in CLL. Mean lymphocyte conductance was significantly increased in CLL and significantly decreased in both acute viral disease and ALL. Mean lymphocyte scatter was significantly decreased in acute viral disease and significantly increased in ALL.

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Hirudin as an anticoagulant for both haematology and chemistry tests

Journal of Automated Methods and Management in Chemistry ◽

10.1155/s1463924600000158 ◽

2000 ◽

Vol 22 (4) ◽

pp. 109-112 ◽

Cited By ~ 3

Author(s):

Takeo Kumura ◽

Masayuki Hino ◽

Takahisa Yamane ◽

Noriyuki Tatsumi

Keyword(s):

Blood Cells ◽

Laboratory Tests ◽

Blood Count ◽

Complete Blood Count ◽

Clinical Chemistry ◽

Laboratory Medicine ◽

Differential Count ◽

Blood Collection ◽

Tetraacetic Acid ◽

Coagulation Pathway

Hirudin, an extract from the leech, has powerful antithrombin activity affecting the blood coagulation pathway. We evaluated the usefulness of hirudin in anticoagulating specimens for routine laboratory tests. Results using blood anticoagulated with hirudin corresponded well with results with blood treated with ethylenediamine tetraacetic acid (EDTA) in the complete blood count (CBC), including white blood cell (WBC) differential count and morphology of blood cells, when CBC was performed within 2 h of blood collection. Clinical chemistry results from hirudin-treated samples were similar to results obtained with serum specimens. Thus, hirudin may be a useful anticoagulant for emergency laboratory medicine.

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Laboratory Productivity and the Rate of Manual Peripheral Blood Smear Review: A College of American Pathologists Q-Probes Study of 95 141 Complete Blood Count Determinations Performed in 263 Institutions

Archives of Pathology & Laboratory Medicine ◽

10.5858/2006-130-596-lpatro ◽

2006 ◽

Vol 130 (5) ◽

pp. 596-601 ◽

Cited By ~ 3

Author(s):

David A. Novis ◽

Molly Walsh ◽

David Wilkinson ◽

Mary St. Louis ◽

Jonathon Ben-Ezra

Keyword(s):

Peripheral Blood ◽

Blood Count ◽

Complete Blood Count ◽

The United States ◽

Differential Count ◽

Cell Parameters ◽

Blood Smears ◽

Peripheral Blood Smears ◽

Manual Review ◽

Differential Counts

Abstract Context.—Automated laboratory hematology analyzers are capable of performing differential counts on peripheral blood smears with greater precision and more accurate detection of distributional and morphologic abnormalities than those performed by manual examinations of blood smears. Manual determinations of blood morphology and leukocyte differential counts are time-consuming, expensive, and may not always be necessary. The frequency with which hematology laboratory workers perform manual screens despite the availability of labor-saving features of automated analyzers is unknown. Objective.—To determine the normative rates with which manual peripheral blood smears were performed in clinical laboratories, to examine laboratory practices associated with higher or lower manual review rates, and to measure the effects of manual smear review on the efficiency of generating complete blood count (CBC) determinations. Design.—From each of 3 traditional shifts per day, participants were asked to select serially, 10 automated CBC specimens, and to indicate whether manual scans and/or reviews with complete differential counts were performed on blood smears prepared from those specimens. Sampling continued until a total of 60 peripheral smears were reviewed manually. For each specimen on which a manual review was performed, participants indicated the patient's age, hemoglobin value, white blood cell count, platelet count, and the primary reason why the manual review was performed. Participants also submitted data concerning their institutions' demographic profiles and their laboratories' staffing, work volume, and practices regarding CBC determinations. The rates of manual reviews and estimations of efficiency in performing CBC determinations were obtained from the data. Setting.—A total of 263 hospitals and independent laboratories, predominantly located in the United States, participating in the College of American Pathologists Q-Probes Program. Results.—There were 95 141 CBC determinations examined in this study; participants reviewed 15 423 (16.2%) peripheral blood smears manually. In the median institution (50th percentile), manual reviews of peripheral smears were performed on 26.7% of specimens. Manual differential count review rates were inversely associated with the magnitude of platelet counts that were required by laboratory policy to trigger smear reviews and with the efficiency of generating CBC reports. Lower manual differential count review rates were associated with laboratory policies that allowed manual reviews solely on the basis of abnormal automated red cell parameters and that precluded performing repeat manual reviews within designated time intervals. The manual scan rate elevated with increased number of hospital beds. In more than one third (35.7%) of the peripheral smears reviewed manually, participants claimed to have learned additional information beyond what was available on automated hematology analyzer printouts alone. Conclusion.—By adopting certain laboratory practices, it may be possible to reduce the rates of manual reviews of peripheral blood smears and increase the efficiency of generating CBC results.

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