Automated Body Fluid Cell Counts

Body fluid cell count has been part of the hematology laboratory and remains a time-consuming manual task for technologists. The cell count test provides valuable information to clinicians in the diagnosis and treatment of a various medical conditions. Albeit the diagnostic prowess of cell counts, there has also been an intrapersonnel variation in counts that proves the lack of precision among testing personnel. As laboratory professionals, we are trained that precision is important in the performance of cell counting procedures; therefore the implementation of automated body fluid counts will improve these quality parameters.

Automated methods for body fluid cell counts have been rapidly replacing manual hemacytometer methods. Advances in medical technology, especially in hematology instrumentation, have decreased the turnaround times and improved precision counts for body fluids. Technological advances in hardware and software engineering have developed instruments with expanded analytical capabilities that enable processing multiple specimen types including urine, CSF, peritoneal fluid, pleural fluid, synovial fluid, and lavages on a single analyzer.1 Most body fluid instruments like the Sysmex XE-5000 have analyzed body fluids easily and quickly. In a study published in Lab Medicine, the Sysmex XE5000 technology showed significant improvement in the ability of automated hematology analyzers regarding body fluid analysis.2 This technology provides counting nucleated cells in an acellular fluid(i.e. Cerebrospinal fluid). This technology also offers differential capabilities between mononuclear and polymorphonuclear cells, providing laboratory technologists and clinicians rapid, cellular differential analysis.

Laboratory technologists should not fear that their jobs will be replaced by these instruments. In fact, laboratory professionals should be enthused that it provides ease in their work, improves quality, decreases work load, and increases efficiency in their processes. The limitations that need to be considered in automated cell counts analyzers are the use of purulent specimens where the main concern is clogging the instrument’s flow cell apertures. Crystals in synovial fluids may cause a false increase in counts; in these cases, manual intervention in cell count may be warranted. Extremely clear fluids with low cell counts also limit the application of automated methods and may warrant manual analysis. Of important consideration as well is the microscopic review of cellular distribution when malignancy is of diagnostic consideration.

Modernization of laboratory equipment and analysis provide ease in operation from a management stand point but also efficiency, accuracy and precision in reporting of results. Automation of body fluid counts provides help to technologists and a rapid diagnosis tool for clinicians.




  1. Scott, G. (2014, June 9). An automated approach to body fluid analysis. Medical Laboratory Observer.

Williams, J., MD. (2011). Gaining Efficiency in the Laboratory – Automated Body Fluid Cell Counts: Evaluation of the Body Fluid Application on the Sysmex XE-5000 Hematology Analyzer . Lab Medicine, 42(7).


Carlo Ledesma, MS, SH(ASCP)CM MT(ASCPi) MT(AMT) is the program director for the Medical Laboratory Technology and Phlebotomy at Rose State College in Midwest City, Oklahoma as well as a technical consultant for Royal Laboratory Services. Carlo has worked in several areas of the laboratory including microbiology and hematology before becoming a laboratory manager and program director.

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