Medical Mattress, Hematology analyzers can do a lot of things these days. They can do a complete blood count, or tot up red or white blood cells, or platelets. They can tell you hemoglobin concentration, hematocrit, RBC indices, and leukocyte differential. Even older machines can do a limited CBC, and a three-part leukocyte differential, giving values for neutrophils, lymphocytes, and all other white cells together. The snazzier ones count monocytes, basophils, and eosinophils too. They can also detect nucleated red blood cells.
Nexgen In certain situations, hematology analyzers are known to provide a falsely low platelet count. This worries some of our customers. In this blog post, we’ll talk about that, and explain why not every machine is the same.
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The accuracy of platelet count is undeniably critical sometimes. It’s how you assess the risk of bleeding in patients, for one thing. Decreased platelet count is seen in things like thrombocytopenic purpura, aplastic anemia, and leukemia. Too many platelets can mean primary thrombocythemia, polycythemia vera, or chronic myelogenous leukemia. Medical Mattress You want to get the numbers right for diagnosis and differential in clinical hemostasis and thrombotic diseases.
Over the years, platelet counting has been done by microscopic tallying, automated blood cell analyzers, and the “international reference method” (or “IRM”), based on flow cytometry, as proposed by the International Council for Standardization in Haematology (ICSH). There’s an “impedance” method in wide use, invented by Beckman Coulter. It has its limitations, like being unable to distinguish platelets from particles of similar size and volume. Instrument manufacturers have tried hard to work around this. The Advia 120, Cell-Dyn 4000, and Mindray BC-6800 are optical platelet counters that differentiate blood components by type and strength of light signals. Another analyzer, the Sysmex XN-3000, does it entirely differently, with fluorescent nucleic acid staining.
The impedance method looks at each platelet passing through a small hole. This detects only volume. So it gets confused with big platelets, small red blood cells, platelet aggregation, and cell debris. Fancy machines like the BC-6000 Plus and the XN-9000 get around this with nucleic acid fluorescence staining. This shows up RNA and part of the DNA in cells and finally distinguishes different matter by the intensity of light signals. There are external confounders sometimes too, like interfering substances in peripheral blood cell smears.
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So why doesn’t everybody use the fluorescence method for every sample? Because it’s expensive, that’s why. This is what a very recent study ended up saying, having also minutely considered the different techniques in particular clinical syndromes. This study looked at 23 different automated blood analyzers, found that most of them produced higher results than the IRM, but all had acceptable sensitivities and concordance rates with the reference method for diagnosis of thrombocytopenia and thrombocytosis. As such, the investigators judged that all 3 automated methods can be used for the screening and ruling out of thrombocytopenia and thrombocytosis in patients with thalassemia. However, they did observe that the specificity of the PLT-I was low for the diagnosis of thrombocytopenia. They ruled that an additional assay test should be used to improve the specificity of thrombocytopenia diagnosis when the PLT-I value is lower than 1003103/lL. PLT-O or PLT-F can be used in this setting owing to their higher specificities and concordance rates with the IRM. Accessories NMW533 That’s if you can afford it. What you buy for your own lab or clinic will probably depend on what you’re trying to do.