![]() Unreliable automated CBC results may be caused by (i) specimen characteristics that interfere with the measurement of one or more CBC parameters, (ii) abnormal cells and/or cellular phenomena that mimic other abnormal or normal cells and therefore are misidentified and miscounted, or (iii) a combination of (i) and (ii). We provide an overview of the current knowledge about the causes of unreliable automated CBC results, ways to recognize them, and means to obtain clinically reliable results. Laboratory professionals are expected to recognize unreliable results, identify the potential cause(s), and be acquainted with the ways to obtain reliable results on such specimens. Inaccurate results, which may adversely affect patient care, are clinically unreliable and require the attention of laboratory professionals. However, every laboratory sometimes encounters specimens that yield no or inaccurate result(s) for one or more CBC parameters even when the analyzer is functioning properly and the manufacturer’s instructions are followed religiously. Appropriately calibrated and quality-controlled automated hematology analyzers operated according to the manufacturer’s instructions generate accurate CBC results on nearly all specimens. Further discussion here is limited to the eight basic CBC parameters as in our opinion, RDW is irrelevant to the subject matter of the article. Some laboratories also include mean PLT volume (MPV) and/or DIFF in the CBC. Automated CBC, also known as hemogram in some parts of the world, typically includes nine parameters: WBC count, red blood cell (RBC) count, Hb, Hct, mean RBC volume (MCV), mean corpuscular Hb content (MCH), mean corpuscular Hb concentration (MCHC), red cell distribution width (RDW), and platelet (PLT) count. Hematology laboratories routinely utilize these analyzers to obtain complete blood count (CBC) results with or without differential white blood cell (WBC) counts (DIFFs) on EDTA-anticoagulated blood specimens. Keywords: Blood cell counts, Automated analyzer, Specimen handling, Problem solvingĪutomated analyzers have become the mainstay of clinical laboratories globally. Pertinent analyzer-specific information can be found in the manufacturers’ operating manuals. Some examples of unreliable automated CBC results are also illustrated. We present a concise overview of the known causes of unreliable automated CBC results, ways to recognize them, and means commonly utilized to obtain reliable results. Laboratory professionals must recognize unreliable results, determine the possible cause(s), and be acquainted with the ways to obtain reliable results on such specimens. ![]() However, every laboratory encounters, at times, some specimens that yield no or inaccurate result(s) for one or more CBC parameters even when the analyzer is functioning properly and the manufacturer’s instructions are followed to the letter. Automated hematology analyzers generate accurate complete blood counts (CBC) results on nearly all specimens.
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