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Related Experiment Videos

Variations in pleural fluid WBC count and differential counts with different sample containers and different methods.

Barrett D Conner1, Y C Gary Lee, Paul Branca

  • 1Department of Pulmonary Medicine, Saint Thomas Hospital and Vanderbilt University, Nashville, TN, USA.

Chest
|April 10, 2003
PubMed
Summary

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Automated white blood cell (WBC) counts in pleural fluid are inaccurate, especially when not using ethylenediaminetetraacetic acid (EDTA) tubes. Manual counting or automated counts in EDTA tubes provide reliable WBC differential results up to 24 hours.

Area of Science:

  • Clinical Chemistry
  • Hematology
  • Laboratory Medicine

Background:

  • Accurate white blood cell (WBC) counts and differentials in pleural fluid are crucial for diagnosing various conditions.
  • Standardization of laboratory methods for pleural fluid analysis is essential for reliable results.

Purpose of the Study:

  • To compare manual versus automated WBC counts and differentials in pleural fluid.
  • To evaluate the impact of different specimen containers on cell counts.
  • To assess the stability of cell counts over a 24-hour period.

Main Methods:

  • Twenty-eight pleural fluid samples were analyzed.
  • Cells were collected in five different tube types: EDTA, citrate, heparin, plain glass, and plain plastic.
  • WBC counts and differentials were performed manually and by automated counter at 4 and 24 hours postcollection.

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Main Results:

  • Manual and automated WBC counts in ethylenediaminetetraacetic acid (EDTA) tubes showed high correlation (r=0.92).
  • Automated counts were significantly lower in non-anticoagulant tubes.
  • Automated differentials were inaccurate in distinguishing neutrophils from monocytes/mesothelial cells, though lymphocyte percentages were similar.
  • WBC counts remained stable for 24 hours when refrigerated.

Conclusions:

  • Manual and automated WBC counts in EDTA tubes are highly correlated for pleural fluid.
  • Using non-anticoagulant tubes leads to lower pleural fluid WBC counts.
  • Automated differential counts lack accuracy for pleural fluid, particularly for neutrophils.
  • Refrigerated storage up to 24 hours does not significantly affect WBC counts or differentials.