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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)

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 

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

United Laboratory Retention: 7 days

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 Manual

0 Minutes up to 1 Months: 7 – 16 %
1 Months up to 3 Years: 5 – 12 %
3 Years up to 13 Years: 3 – 11 %
13 Years up to 150 Years: 0 – 10 %

 

Basosphilis Manual

0 – 2 %

 

Eosinophils Manual

0 – 6 %

 

Hematocrit (Hct)

0 Minutes up to 1 Month: 42.0 – 64.0 %
1 Month up to 3 Months: 38.0 – 56.0 %
3 Months up to 1 Year: 33.0 – 48.0 %
1 Year up to 3 Years: 32.0 – 44.0 %
3 Years up to 9 Years: 35.0 – 45.0 %
9 Years up to 13 Years: 37.0 – 47.0 %

Male

13 Years up to 150 Years: 42.0 – 52.0 %

Female

13 Years up to 150 Years: 37.0 – 47.0 %

 

Hemoglobin (Hgb)

0 Minutes up to 1 Month: 15.5 – 21.0 g/dL
1 Month up to 3 Months: 12.5 – 19.0 g/dL
3 Months up to 1 Year: 10.5 – 16.0 g/dL
1 Year up to 3 Years: 10.0 – 14.0 g/dL
3 Years up to 9 Years: 11.5 – 14.5 g/dL

Male

9 Years up to 13 Years: 12.5 – 16.0 g/dL
13 Years up to 150 Years: 14.0 – 18.0 g/dL

Female

9 Years up to 13 Years: 12.0 – 15.0 g/dL
13 Years up to 150 Years: 12.0 – 16.0 g/dL

 

Lymphocyte Manual (%)

0 Minutes up to 1 Month: 30 – 66 %
1 Month up to 3 Years: 42 – 75 %
3 Years up to 9 Years: 30 – 66 %
9 Years up to 13 Years: 25 – 50 %
13 Years up to 150 Years: 20 – 50 %

 

Mean Cell Hemoglobin (MCH)

0 Minutes up to 1 Month:  32.0– 41.0 pg

1 Month up to 3 Months:  30.0 – 38.0 pg

3 Months up to 1 Year:  27.0 – 35.0 pg

1 Year up to 3 Years:  23.0 – 30.0 pg

3 Years up to 9 Years:  25.0 – 32.0 pg

9 Years up to 150 Years:  27.0 – 33.0 pg

 

Mean Cell Hemoglobin Concentration (MCHC)

0 Minutes up to 1 Month:  35.0 – 38.0 g/dL

1 Month up to 3 Months:  34.0 – 37.0 g/dL

3 Months up to 1 Year:  33.0 – 37.0 g/dL

1 Year up to 150 Years:  32.0 – 37.0 g/dL

 

Mean Cell Volume (MCV)

0 Minutes up to 1 Month:  94.0 – 116.0 fL

1 Month up to 3 Months:  84.0 – 104.0 fL

3 Months up to 3 Years:  74.0 – 90.0 fL

3 Years up to 9 Years:  80.0 – 94.0 fL

9 Years up to 13 Years:  84.0 – 98.0 fL

13 Years up to 150 Years:  80.0 – 100.0 fL

 

Monocyte Manual (%)

2 - 12 %

 

Mean Platelet Volume (MPV)

7.4 - 11.0 fL

 

Neutrophil Absolute Count

0 Minutes up to 1 Month:  2.00 – 10.00  ( x 103/uL)

1 Month up to 13 Years:  1.50 – 6.00  ( x 103/uL)

13 Years up to 150 Years:  1.80 – 7.80  ( x 103/uL)

 

Nucleated Red Blood Cell (NRBC) Absolute Count

0.00 - 0.01 x 103/uL

 

Nucleated Red Blood Cell (NRBC) Automated ( %)

0.0 - 0.1%

 

Platelet

140 - 400  ( x 103/uL)

 

Red Blood Cell (RBC)

Male:

0 Minutes up to 1 Month:  4.60 – 6.20 (x 106/uL)

1 Month up to 3 Months:  4.40 – 5.80  (x 106/uL)

3 Months up to 13 Years:  4.20 – 5.20  (x 106/uL)

13 Years up to 150 Years:  4.60 – 6.00  (x 106/uL)

Female:

0 Minutes up to 1 Month:  4.60 – 6.20  (x 106/uL)

1 Month up to 3 Months:  4.40 – 5.80  (x 106/uL)

3 Months up to 13 Years:  4.20 – 5.20  (x 106/uL)

13 Years up to 150 Years:  4.20 – 5.40  (x 106/uL)

 

Red Cell Diameter Width (RDW)

11.0 - 16.0 %

 

Segmented Neurtrophils Manual

0 Minutes up to 1 Months: 16 – 50 %
1 Months up to 3 Years: 13 – 35 %
3 Years up to 9 Years: 25 – 55 %
9 Years up to 13 Years: 30 – 62 %
13 Years up to 150 Years: 35 – 80 %

 

White Blood Cell (WBC)

0 Minutes up to 1 Month:  6.00 – 20.00 (x 103/uL)

1 Month up to 3 Years:  6.00 – 18.00  (x 103/uL)

3 Years up to 9 Years:  5.00 – 15.00  (x 103/uL)

9 Years up to 13 Years:  4.50 – 12.00  (x 103/uL)

13 Years up to 150 Years:  4.00 – 10.80  (x 103/uL)

 

The pediatric data is summarized /compiled from the literature.

 

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