When is an abnormal blood count further examined with a microscope?

An abnormal blood count is further investigated with a microscopic examination when immature, abnormal or abnormally shaped blood cells are detected. This provides a more accurate assessment of possible conditions such as infections or blood diseases.

A blood test is an important tool for understanding a person's state of health. In a comprehensive blood count, such as the Comprehensive Blood Count including Leuco Diff, different types of blood cells are counted and analyzed. But what happens if the results show abnormalities? In some cases, it may be necessary to further examine the blood count using microscopic analysis, as with the Comprehensive Blood Count with Microscope. In this blog, I explain when automatic further testing occurs and why this is important.

What is a leukocyte differentiation?

A leukocyte differential (or "diff") is a standard part of many blood tests that measure the number and ratio of different types of white blood cells. This is important because abnormalities in these white blood cells can indicate various conditions, such as infections, inflammation, allergies or even malignant diseases such as leukemia.

When is additional microscopic assessment needed?

Modern technology makes it possible to analyze blood cells on a large scale using sophisticated equipment. This equipment can classify cells based on size, structure and sometimes even the internal composition of the cell. In most cases, this method is sufficient to provide an accurate picture of the various blood cells in the body.

However, there are situations in which the results of this computer-based analysis are anomalous, such as:

• Unusual cell shapes: If the analyzer detects cells that do not match the expected shapes, such as immature or abnormally shaped blood cells, this may indicate conditions such as anemia or bone marrow disorders.
• Excessive variation in cell size or color: This can occur, for example, with vitamin B12 deficiency or iron deficiency.
• Presence of immature or abnormal blood cells: In diseases such as leukemia, immature forms of blood cells (blasts) may appear in the bloodstream. These abnormal cells are often not fully recognized by the machine.
• Parasites in blood cells: Some parasites, such as the malaria parasite, can only be seen under a microscope.

In these cases, an automatic referral will be made to a microscopic examination. A microscopic analysis is more accurate and can detect subtle abnormalities that may be overlooked by the machine.

How does a microscopic blood test work?

A microscopic examination begins with the preparation of a blood smear. A drop of blood is smeared onto a slide and then stained using a special technique, such as May-Grünwald-Giemsa staining. This staining helps to better visualize the different types of blood cells and their internal structures. The smear is then evaluated under a microscope by a trained analyst. Here, the following characteristics, among others, can be assessed:

• The color and size of blood cells: Abnormalities may indicate such things as iron deficiency or other nutritional deficiencies.
• The presence of parasites: As mentioned earlier, malaria can be detected with a microscopic examination.
• The shape of the nucleus of blood cells: This is an important indicator of various blood diseases, such as leukemia or other bone marrow disorders.

Why is this follow-up analysis important?

Although modern analyzers are very accurate, they are not always able to detect all subtle abnormalities. A microscopic examination offers a more detailed assessment, especially when serious abnormalities such as leukemia, infections or other hematologic conditions are suspected. This allows a physician to make a better diagnosis and develop a targeted treatment plan.

Why is automatic testing continued?

If an abnormal blood count is detected, a microscopic examination is automatically performed because the blood sample has a short shelf life. The EDTA blood, which is used for these tests, cannot be stored for long until approval is obtained for further testing. To prevent the blood sample from becoming unusable, testing continues immediately without waiting for approval. When ordering a blood image test, you automatically agree to this follow-up step and the associated costs if further testing proves necessary. This ensures that analysis can take place quickly and efficiently.

How common is the blood count to be tested through?

The percentage in which a follow-up test automatically occurs after an abnormal blood count varies, but in practice it occurs in about 5-10% of cases. This usually depends on the specific test results and the degree of abnormality observed. For example, if there are obvious abnormalities in the cell shapes, numbers or maturity of the cells, it is often decided to proceed immediately to a microscopic examination to further investigate the cause and provide an accurate diagnosis.

Conclusion

When a Comprehensive Blood Count including Leuco Diff shows abnormalities, such as unusual cell shapes or abnormal results in the ratio of different white blood cells, this may warrant further investigation. In this case, further testing is automatically performed using microscopic analysis. This additional step is crucial to accurately detect possible underlying conditions, such as infections, anemia or leukemia.

Do you have questions about your blood count or would you like to have a comprehensive blood test done yourself? Then feel free to contact us. we will help you further k with expert advice and reliable tests.

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