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Test Code LAB2111032 Complete Blood Count (CBC) w/ Manual Differential

Test Name Alias

CBC w/ ManDiff | 8398

Icons & Photos

Collection Instructions

Specimen Collection: Blood

 

Container(s): Lavender top (EDTA)

Preferred Volume to Collect: 3.0 mL

Minimum Volume to Collect: 0.5 mL

Neonate Volume to Collect: 0.5 mL

Capillary collect ok? Yes

Microtainer acceptable: Yes

 

Collection Instructions:

  • After collection, gently invert tube 8-10 times.

  • Specimen must be received within 6 hours of collection if ambient, 10 hours if refrigerated (see stability information below)
    • United Lab: 10 hours if ambient, 10 hours if refrigerated

Processing Instructions (Laboratory, Outpatient or Off-site collection)

Processed Specimen: Whole Blood EDTA

 

Centrifuge/Spin: No

Aliquot: No

 

Transport Temperature: Refrigerate (preferred) or Ambient (acceptable)

Specimen Stability

Ambient: 6 hours (10 hours at United Lab)

Refrigerate: (preferred) 10 hours

Note: Cellular characteristics required for differential analysis become compromised in specimens greater than 10 hours due to degradation of cells

Laboratory Retention: 72 hours (7 days at United Lab)

Reflex Information

Mandatory Reflex approved by MEC

  • CBC with manual differential will reflex to CBC without differential "if" the WBC is less than 0.4
  • CBC with manual differential will reflex to CBC without differential "if" requested within 24 hours
  • CBC with manual differential will reflex to Immature Platelet Fraction if platelet count <75,000.

Optional Reflex Testing (requires additional physician orders):

  • Pathologist review -Required CBC with manual differential results with unstained peripheral smear.

Test Frequency

Available 24 hours, usual TAT 1 day.

Reference Range

Bands Man
Male/Female
0 Minutes – 1 Months: 7 – 16 %
1 Months – 3 Years: 5 – 12 %
3 Years – 13 Years: 3 – 11 %
13 Years – 150 Years: 0 – 10 %

 

Basophil
Male/Female
0 Minutes – 150 Years: 0 – 2 %

 

Eos
0 – 6 %

 

Hct
Male/Female
0 Minutes – 1 Months: 42 – 64 %
1 Months – 3 Months: 38 – 56 %
3 Months – 1 Years: 33 – 48 %
1 Years – 3 Years: 32 – 44 %
3 Years – 9 Years: 35 – 45 %
9 Years – 13 Years: 37 – 47 %

Male
13 Years – 150 Years: 42 – 52 %

Female
13 Years – 150 Years: 37 – 47 %

 

Hgb
Male/Female
0 Minutes – 1 Months: 15.5 – 21 g/dL
1 Months – 3 Months: 12.5 – 19 g/dL
3 Months – 1 Years: 10.5 – 16 g/dL
1 Years – 3 Years: 10 – 14 g/dL
3 Years – 9 Years: 11.5 – 14.5 g/dL

Male
9 Years – 13 Years: 12.5 – 16 g/dL
13 Years – 150 Years: 14 – 18 g/dL

Female
9 Years – 13 Years: 12 – 15 g/dL
13 Years – 150 Years: 12 – 16 g/dL

 

IG %  

0.1 - 0.6 %

 

IG Absolute

0.01 to 0.05 x 103/uL 

 

Lymph
Male/Female
0 Minutes – 1 Months: 30 – 66 %
1 Months – 3 Years: 42 – 75 %
3 Years – 9 Years: 30 – 66 %
9 Years – 13 Years: 25 – 50 %
13 Years – 150 Years: 20 – 50 %

 

MCH
Male/Female
0 Minutes – 1 Months: 32 – 41 pg
1 Months – 3 Months: 30 – 38 pg
3 Months – 1 Years: 27 – 35 pg
1 Years – 3 Years: 23 – 30 pg
3 Years – 9 Years: 25 – 32 pg
9 Years – 150 Years: 27 – 33 pg

 

MCHC
Male/Female
0 Minutes – 1 Months: 35 – 38 g/dL
1 Months – 3 Months: 34 – 37 g/dL
3 Months – 1 Years: 33 – 37 g/dL
1 Years – 150 Years: 32 – 37 g/dL

 

MCV
Male/Female
0 Minutes – 1 Months: 94 – 116 fL
1 Months – 3 Months: 84 – 104 fL
3 Months – 3 Years: 74 – 90 fL
3 Years – 9 Years: 80 – 94 fL
9 Years – 13 Years: 84 – 98 fL
13 Years – 150 Years: 80 – 100 fL

 

Mono
2 – 12 %

 

MPV

7.4 – 11 fL

 

Neut Absolute
Male/Female
0 Minutes – 1 Months: 2 – 10  ( x 103/uL)
1 Months – 13 Years: 1.5 – 6   ( x 103/uL)
13 Years – 150 Years: 1.8 – 7.8  ( x 103/uL)

 

NRBC Absolute

0.00 - 0.01 x 103/uL

 

NRBC %

0.0 - 0.1%

 

Platelet
140 – 400  ( x 103/uL)

 

RBC
Male
0 Minutes – 1 Months: 4.6 – 6.2 ( x 106/uL)
1 Months – 3 Months: 4.4 – 5.8  ( x 106/uL)
3 Months – 13 Years: 4.2 – 5.2  ( x 106/uL)
13 Years – 150 Years: 4.6 – 6  ( x 106/uL)

Female
0 Minutes – 1 Months: 4.6 – 6.2  ( x 106/uL)
1 Months – 3 Months: 4.4 – 5.8  ( x 106/uL)
3 Months – 13 Years: 4.2 – 5.2  ( x 106/uL)
13 Years – 150 Years: 4.2 – 5.4  ( x 106/uL)

 

RDW
11 – 16 %

 

Segs Man
Male/Female
0 Minutes – 1 Months: 16 – 50 %
1 Months – 3 Years: 13 – 35 %
3 Years – 9 Years: 25 – 55 %
9 Years – 13 Years: 30 – 62 %
13 Years – 150 Years: 35 – 80 %

 

WBC
Male/Female
0 Minutes – 1 Months: 6 – 20 ( x 103/uL)
1 Months – 3 Years: 6 – 18  ( x 103/uL)
3 Years – 9 Years: 5 – 15  ( x 103/uL)
9 Years – 13 Years: 4.5 – 12  ( x 103/uL)
13 Years – 150 Years: 4 – 10.8  ( x 103/uL)

 

Laboratory Critical Values Table

Performing Department

HEMATOLOGY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI
Spectrum Health Big Rapids Laboratory, Big Rapids, MI
Spectrum Health Blodgett Laboratory, Grand Rapids, MI
Spectrum Health Gerber Laboratory, Fremont, MI
Spectrum Health Kelsey Laboratory, Lakeview, MI
Spectrum Health Ludington Laboratory, Ludington, MI
Spectrum Health Pennock Laboratory, Hastings, MI
Spectrum Health Reed City Laboratory, Reed City, MI
Spectrum Health United Laboratory, Greenville, MI
Spectrum Health Zeeland Laboratory, Zeeland, MI

Methodology

Sysmex

 

The analyzer counts and sizes red blood cells (RBC) and platelets (PLT) using electronic resistance detection enhanced by hydrodynamic focusing. Hematocrit (HCT) is measured as the ratio of the total RBC volume to whole blood using cumulative pulse height detection. Hemoglobin (HGB) is converted to SLS-hemoglobin and read photometrically.

 

WBC count, differential, reticulocytes (RET) and nucleated red blood cells (NRBC) are all evaluated using flow cytometry with a semiconductor laser exploiting the differences in cell size, complexity and RNA/DNA content. WBC and basophils (BASO) are treated with an acidic lyse that lyses RBC and WBC, but not BASO. The remaining WBC nuclei and intact BASO are differentiated by cell size and internal cell structure. The WBC differential channel classifies lymphocytes (LYMPH), monocytes (MONO), eosinophils (EO), granulocytes, and immature granulocytes (IG) by cellular complexity and nucleic acid content. The differential cell placement is then enhanced using Adaptive Cluster Analysis. Reticulocytes are separated from mature RBC and PLT by size and RNA content. NRBC are separated from WBC based on nuclear size after lysing and DNA/RNA staining.

 

The Immature Information channel (IMI) cytochemically differentiates immature myeloid cells from mature granulocytes based on the membrane lipid content, and direct current and radio frequency technologies.

CPT

85027

85007

85055-IPF Reflex

CDM Code

4068397, 4068369

Epic Test ID

1230102042

Interface Order Alias

10032

Reviewed Date

3/30/2018