Low wbc and rbc
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Understanding Low White Blood Cell (WBC) and Red Blood Cell (RBC) Counts
Introduction to Low WBC and RBC Counts
Low counts of white blood cells (WBC) and red blood cells (RBC) can indicate various health conditions and are critical parameters in medical diagnostics. Accurate measurement of these cells, especially at very low concentrations, is essential for effective patient management.
Methods for Measuring Low WBC Counts
Manual Counting Techniques
One method for counting very low WBC concentrations involves using a Nageotte hemocytometer, which has a large-volume chamber. This technique is validated for its accuracy in detecting WBCs in red cell and platelet suspensions, with a detection limit of 0.01 WBC per microL1.
Automated Hematology Analyzers
Automated hematology analyzers, such as the Sysmex XN-Series, have specialized modes for measuring low WBC counts. The body fluid (BF) mode, in particular, offers high accuracy by using a larger sample volume and performing multiple background checks to minimize carry-over effects. This mode can measure WBC counts as low as 0.001 x 10^9/L, providing reliable results even at extremely low concentrations2.
Fluorescence Hemocytometry and Cytospin Techniques
Another approach involves harvesting WBCs from large volumes of RBCs and concentrating them for counting using fluorescence hemocytometry or a modified cytospin technique. These methods can detect WBC concentrations as low as 200 WBCs per unit of RBCs, making them suitable for measuring very low WBC levels3.
Methods for Measuring Low RBC Counts
Flow Cytometry
Flow cytometry is a novel method for detecting low levels of residual RBCs and platelets in WBC-reduced plasma. This technique uses dual monoclonal antibodies and fluorescent beads to achieve high sensitivity, capable of detecting RBC concentrations as low as 50 x 10^6 cells/L4.
Automated Hematology Analyzers for RBCs
The Abbott Alinity Hq body fluid mode is another automated method that accurately determines low RBC concentrations in cerebrospinal fluid. However, it is limited to reporting RBC counts above 1,000 cells/μL5.
Challenges and Considerations
Spurious Counts and Accuracy
Automated hematology analyzers can sometimes produce spurious counts due to factors like agglutination, cryoglobulins, and insufficiently lysed RBCs. These issues can lead to inaccurate WBC and RBC counts, necessitating manual verification in some cases8 9.
Low-Cost Alternatives
Innovative low-cost systems using image processing techniques have been developed to estimate RBC and WBC counts. These systems offer a cost-effective alternative to traditional methods, with accuracy rates of around 91.2%6.
Conclusion
Accurate measurement of low WBC and RBC counts is crucial for diagnosing and managing various health conditions. While manual counting methods and advanced automated analyzers provide reliable results, challenges like spurious counts and the need for cost-effective solutions remain. Continuous advancements in technology and methodology are essential to improve the accuracy and accessibility of these critical diagnostic tests.
Sources and full results
Most relevant research papers on this topic
Validation of a simple method to count very low white cell concentrations in filtered red cells or platelets
A simple manual method using a Nageotte hemocytometer can accurately count very low white cell concentrations in filtered red cells or platelets, with a limit of accurate detection (10) reached when 10 cells are observed.
Highly CitedEvaluation of the body fluid mode of automated hematology analyzer XN‐series for extremely low peripheral white blood cell counts
The body fluid mode of the XN-Series automated hematology analyzer provides more accurate measurements of total and differential white blood cell counts in extremely low WBC ranges.
Methods for measuring a 6 log10 white cell depletion in red cells
This method allows for the measurement of very low white cell concentrations in red cells, enabling the detection of more than 6 log10 white cell depletion in red cells without reaching the sensitivity limit of either technique.
Residual red cell and platelet content in WBC-reduced plasma measured by a novel flow cytometric method.
This study developed a novel flow cytometric method for detecting low levels of red blood cells, platelets, and platelet-MV in WBC-reduced plasma, making it suitable for routine quality monitoring and setting new specifications.
In Vitro StudyThe Abbott Alinity Hq body fluid mode accurately determines low RBC concentrations in cerebrospinal fluid
The Abbott Alinity Hq body fluid mode accurately determines low RBC concentrations in cerebrospinal fluid, enabling accurate differentiation between pathological and normal specimens.
Development of Low Cost System for Estimating RBC, WBC Count Using Image Processing
The proposed low-cost system using image processing and edge detection algorithms accurately estimates RBC and WBC counts, providing a faster and more accurate method for blood-related diseases detection.
Low-Level Light Therapy Protects Red Blood Cells Against Oxidative Stress and Hemolysis During Extracorporeal Circulation
Low-level light therapy with red-to-near-infrared radiation can reduce blood trauma caused by extracorporeal circulation during surgery by stabilizing red blood cell membranes and limiting inflammation.
RCT
Animal Study[Automated hematology analysers and spurious counts Part 2. Leukocyte count and differential].
Automated hematology analysers provide accurate results for white blood cell counts and differentials, but basophilic granulocytes and monocytes may be missed, and simple analysers may not detect abnormal results as effectively.
Spurious counts and spurious results on haematology analysers: a review. Part II: white blood cells, red blood cells, haemoglobin, red cell indices and reticulocytes
Haematology analysers can produce spurious results due to factors such as agglutination, lipids, and technological considerations, and sophisticated models can detect anomalous results.
Highly CitedA Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status
Pregnant women at high altitude have lower WBC, higher platelets, and higher serum ferritin, testosterone, and hepcidin, with varying effects on iron status and inflammation during gestation.
Observational Study