Cell counting of body fluids: comparison between three automated haematology analysers and the manual microscope method

Danise, Paolo; Maconi, Mariacaterina; Rovetti, A.; Avino, Daniela; Palma, A. Di; Pirofalo, M. Gerardo; Esposito, Ciro

doi:10.1111/ijlh.12093

Cited by 40 publications

(37 citation statements)

References 9 publications

(11 reference statements)

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“…One study, limited to pleural fluids, showed that samples in EDTA tubes gave total WBCs nearly identical to the results obtained with the manual method; conversely specimens in tubes without an anticoagulant gave significantly different results 33. For CSFs, when information about the container used was given, it was usually sterile containers without anticoagulants that were used 17 22 26 29 31 34 36 46 47 49 54…”

Section: Specimen Containers and Exclusion Criteriamentioning

confidence: 96%

“…As for the total WBC count, the WBC differential was more accurate with higher WBC counts and analysis was sometimes restricted to fluids with higher WBC counts 23 29 30 40 43. The Horiba Pentra DX120 had good agreement with the manual WBC differential for peritoneal and pleural fluids, but not for CSF, and this was attributed to the much lower WBC counts in many CSF specimens 26. Poor differential counts were given by some analysers with either pleural fluids23 33 or peritoneal fluids;23 poor performance on these fluids, when it happened, was usually attributed to the presence of nucleated cells other than blood cells.…”

Section: Limitations Of Flow Cytometrymentioning

confidence: 99%

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Flow cytometry for the microscopy of body fluids in patients with suspected infection

Bignardi

2015

J Clin Pathol

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Automating the microscopy of body fluids is challenging, due to the wider range and lower concentrations of cells in these fluids, as opposed to blood, while the viscous nature of some of these fluids can also be problematic. This review shows that there have been major improvements and that newer flow cytometers can have remarkably low limits of quantitation for WBCs. Accurate counting of RBCs is still problematic with many flow cytometers, but this is of no clinical significance. Many flow cytometers can give reasonably accurate WBC differential counts, but detection of eosinophils and neoplastic or other nucleated cells which are not blood cells can still be problematic, hence fail-safe measures are recommended. Cerebrospinal fluid is the most challenging body fluid as it requires the ability to count and differentiate WBCs down to a 'normal range', which is much lower than the diagnostic cut-off values used for serous fluids; precision at or around the cerebrospinal fluid WBC normal range is reduced even with the best flow cytometers, but manual microscopy is even less precise.

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Section: Specimen Containers and Exclusion Criteriamentioning

confidence: 96%

Section: Limitations Of Flow Cytometrymentioning

confidence: 99%

Flow cytometry for the microscopy of body fluids in patients with suspected infection

Bignardi

2015

J Clin Pathol

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“…The following CSF parameters are reported: RBC, WBC, three-part differential (neutrophils, lymphocytes, monocytes), PMN and mononuclear (MN) cells. The eosinophil count is available Comparison studies between conventional microscopy and the ADVIA CSF assay showed acceptable results in CSF, serous fluids and SFs [110][111][112][113][114][115][116][117][118][119]. Common difficulties observed amongst studies were: 1) absence of morphological flagging (making it difficult to detect abnormality in samples); 2) presence of high RBC ( > 1500 × 10 6 /L) counts, (leading to falsely increased WBCs because of overflow in the fixed WBC clusters); and 3) incorrect classification of malignant cells, macrophages, atypical lymphocytes and degenerated neutrophil cells (leading to imprecise differential counts).…”

Section: Advia Analyzers (Siemens Healthcare Diagnostics Deerfield mentioning

confidence: 99%

Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease

Fleming

Russcher

Lindemans

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:In many inflammatory diseases, the cellular components in body fluids [cerebrospinal fluid (CSF), serous fluids] are increased, rendering essential diagnostic information. The diagnostic value of the total white blood cell count (WBC) and differential count has been evaluated extensively over the years, and a remarkable amount of knowledge has been gained; yet, there is a great deal of clinical uncertainty whether the diagnosis should be based solely on these variables. In some diseases, such as peritonitis, the total WBC and differential count has high sensitivity; whereas, in differentiating pleural effusions, it lacks the sensitivity required to be clinically useful. Nevertheless, many guidelines consider these tests as cornerstone parameters, and in combination with clinical variables, they can successfully guide clinical decision making in initiating or postponing a treatment course for infection and/or inflammatory diseases while awaiting culture results. Although other methods are available for detecting and differentiating WBCs in body fluids, manual microscopy is still considered the gold standard despite its many limitations. During the last decade, automated analyzers have become a popular method for first line screening. Continued progress in their design has led to major improvements including their speed, improved accuracy and lower variability compared with microscopy. Disadvantages of this method include high imprecision in low ranges (depending on the method) and interfering factors.In a time where automation is at the front line in clinical laboratories, it is essential the results obtained are precise, accurate and reproducible. This review provides an overview of the relevance for cell counting in a variety of diagnostic body fluids, and highlights the current technologies used.

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“…Similar results were observed by Denise et al, in which the comparison was done using three different automated analyzers. 6 While in the study by Daikelly et al, the analyzer detected small numbers of cells when compared to manual counts. 2 The correlation coefficient for the entire range of data was 0.99.…”

Section: Discussionmentioning

confidence: 94%

Evaluation of Automated Cell Counts in Body Fluids Using Sysmex Xt-4000i - An Important Need of the Day!

Parthasarathi¹,

Prasad²,

Jayaram³

et al. 2016

jemds

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Cell counts in body fluids provide information to clinicians for diagnosis and treatment of a wide variety of medical conditions. Routinely, the analysis of cell counts is performed manually using a haemocytometer due to numerous limitations in manual inspection and counting. Automated counters are therefore employed to perform the test faster and with more accuracy. OBJECTIVETo compare the results of manual and automated White Blood Cell (WBC) counts in serous body fluids. METHODSA prospective study of 130 samples were performed manually using the improved Neubauer chamber with the same samples also being analysed on Sysmex XT-4000i. RESULTSIt was observed that there is a statistically significant correlation between the values obtained in peritoneal and pleural f luids, but this is not the case with cerebrospinal fluid. CONCLUSIONSThe Body Fluid Mode (BFM) of the Sysmex XT-4000i is a fast, reliable and accurate to count WBC's in body fluids.

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Cell counting of body fluids: comparison between three automated haematology analysers and the manual microscope method

Cited by 40 publications

References 9 publications

Flow cytometry for the microscopy of body fluids in patients with suspected infection

Flow cytometry for the microscopy of body fluids in patients with suspected infection

Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease

Evaluation of Automated Cell Counts in Body Fluids Using Sysmex Xt-4000i - An Important Need of the Day!

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