Related Experiment Video
Updated: Nov 9, 2025
Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
Differential white blood cell counts in rabbits: a comparison of the Advia 2120 and a manual method
Ioannis L Oikonomidis1, Elspeth Milne1, Chiara Piccinelli1
1Easter Bush Pathology, Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Roslin, UK.
Abstract:
We evaluated the performance of the Advia 2120 (Siemens) differential leukocyte count (A-Diff) compared to the manual method (M-Diff) in rabbits. EDTA-anticoagulated blood samples collected for diagnostic purposes were analyzed within 6 h of collection. The M-Diff was performed blindly by 2 observers on blood smears by counting 200 cells. We initially included 117 samples; 25 samples were excluded because of suboptimal gating of leukocytes in the Advia peroxidase cytogram or poor blood smear quality. The correlation between the A-Diff and M-Diff was very high for heterophils (r = 0.924, p < 0.001) and lymphocytes (r = 0.903, p < 0.001), high for basophils (r = 0.823, p < 0.001), moderate for monocytes (r = 0.645, p < 0.001), and low for eosinophils (r = 0.336, p = 0.001). The Passing-Bablok regression analyses revealed a small-to-moderate constant error for lymphocytes and a slight constant error for basophils. Small proportional errors were detected for heterophils, lymphocytes, and eosinophils. The Bland-Altman analyses revealed that the Advia significantly underestimates heterophils and overestimates lymphocytes compared to M-Diff. The biases for the other leukocytes were minimal and likely clinical insignificant; however, our results, particularly for eosinophils, should be interpreted cautiously given the observed low percentages in our samples. Given the observed biases in heterophil and lymphocyte percentages in the Advia 2120 CBC results in rabbits, method-specific reference intervals should be used. The Advia can recognize leporine basophils. Evaluation of blood smears is still recommended to investigate abnormal results and erroneous cytograms reported by the Advia.
Insights
The Advia 2120 automated analyzer shows high correlation for rabbit heterophils and lymphocytes but underestimates heterophils and overestimates lymphocytes. Method-specific reference intervals are recommended for accurate Advia 2120 CBC results in rabbits.
Area of Science:
- Veterinary Hematology
- Comparative Pathology
- Laboratory Medicine
Background:
- Accurate differential leukocyte counts are crucial for diagnosing diseases in rabbits.
- Automated hematology analyzers offer efficiency but require validation for each species.
Purpose of the Study:
- To evaluate the performance of the Advia 2120 differential leukocyte count (A-Diff) against manual differential counts (M-Diff) in rabbits.
- To identify potential biases and limitations of the Advia 2120 in rabbit hematology.
Main Methods:
- Comparison of Advia 2120 A-Diff with M-Diff on 92 rabbit blood samples.
- Statistical analysis included correlation (Pearson's r), Passing-Bablok regression, and Bland-Altman analysis.
- Manual counts were performed by two blinded observers on blood smears.
Main Results:
- High correlation (r > 0.90) for heterophils and lymphocytes.
- Moderate correlation for monocytes (r=0.645) and high for basophils (r=0.823).
- Low correlation for eosinophils (r=0.336).
- Advia 2120 showed significant underestimation of heterophils and overestimation of lymphocytes.
- Constant and proportional errors were detected for several leukocyte types.
Conclusions:
- The Advia 2120 demonstrates variable accuracy for differential leukocyte counts in rabbits.
- Method-specific reference intervals are necessary for Advia 2120 complete blood count (CBC) results in rabbits.
- Manual blood smear evaluation remains essential for verifying abnormal results and cytograms.
