Glossary

Pre-differentiation of the white blood cells into three subpopulations. The major advantage of automated cell differentiation is speed and enhanced precision and accurracy: In contrast to a 100-cell manual differential count, automated analysers count on average 15,000 cells/sample.

Sysmex distinguishes lymphocytes, neutrophils and a mixed population consisting of monocytes, basophils and eosinophils. With other technologies, one commonly finds the differentiation into lymphocytes, monocytes and the mixed population of granulocytes. To determine a separate neutrophil population is advantageous since neutrophils are earlier markers for inflammation and infectious conditions than monocytes.

Full differentiation of the white blood cells into the five major subpopulations that physiologically appear in certain concentrations in peripheral blood: lymphocytes, monocytes, eosinophils, basophils and neutrophils. The ability of 5-part differential analysers to enumerate also the less abundant cell types (monocytes, eosinophils and basophils) separately is a significant enhancement.

The results are reported in percentage counts of the total WBC count and in absolute counts , since absolute counts are more informative: In disease, ratios become distorted and therefore percentage counts meaningless in the absence of absolute values.

The principal difference to 3-part differential technology is that cell identification relies on a three-dimensional analysis rather than just on cell size, which allows the identification of immature and abnormal cells, which in turn helps to identify the possible cause of illness in sick people.

Newer automated haematology analysers are able to classify immature granlulocytes (IG) as a sixth population and report them as a percentage count of the total WBC count and an absolute count.

Metalloprotease enzyme that cleaves von Willebrand factor (vWF)

Global parameter to monitor the so-called intrinsic coagulation factors, therapy with heparin and to detect the presence of lupus anticoagulant (LA).

Sysmex's method to evaluate individual cells' signals during measurement and determining the population cluster to which these cells belong. Since this method allows greater flexibility, biological variation between patients is taken into account, leading to more accurate differentiation results, particularly with pathological samples, where morphological appearance of the cells is likely to become altered in disease.

Extended parameters on selected Sysmex haematology analysers: IG, RET-He, IPF, NRBC, Extended Inflammation Parameters, XN Stem Cells; they offer added value exceeding the classical haematology analysis and the basis to generate clinical insight.

Albumin is a small soluble protein that is synthesized in the liver and contained in blood. Albumin is the most abundant protein in blood and serves as an important binding and transport protein. When kidneys are working correctly, they keep important elements such as albumin in the blood. Healthy individuals excrete only low levels of protein through urine on a daily basis. In contrast to this, albuminuria is a pathological condition with larger amounts (>30 mg/24 h) of albumin being present in urine over a longer period. This abnormal condition can be used for an early recognition of nephropathy. The early diagnosis of (micro-)albuminuria can prevent or postpone severe kidney damage.

Glycoprotein which inhibits the serine proteases of plasmatic coagulation, mainly thrombin (factor IIa) and factor Xa.

Healthy urine usually does not contain bacteria. However, some bacteria can be present if the urine sample was not collected under sterile conditions or if the person is suffering from a urinary tract infection. Bacteria can be differentiated into Gram-positive and Gram-negative bacteria, based on their cell wall composition. Depending on the type of the cell wall, they are susceptible to different antibiotics.

Basophils are the white blood cells least represented in the peripheral blood and belong to the category of granulocytes. Similar to eosinophils, an increase in the basophil count often though not always points to allergy or parasitic infections. They function together with mast cells as effector cells in complex processes like chemotaxis or cell adhesion and fulfil an immune modulating role during allergic reactions.

Bilirubin is generated during the breakdown of haemoglobin which is mainly released during the degradation of old red blood cells in the reticuloendothelial system. It is then bound to albumin and transported through the blood to the liver.
Pathological processes that increase the concentration of conjugated bilirubin in plasma also lead to elevated levels of bilirubin in urine, such as fibrosis and swelling, or necrosis of liver cells.

The Blood Bank mode is a new optional licence that can be installed on XN-1000 or XN-2000 analysers to enable the measurement of blood products namely red blood cell concentrates and platelet concen-trates.

Type of body fluid sample material, typically for veterinary samples.

Implies the added value of parameters or their combinations for both diagnosis and therapy/monitoring, which is based on proven evidence only.

Classical 8 parameter haematological blood analysis comprising the counts of RBC, WBC and PLT, plus the determination of the HGB, HCT, MCV, MCH and MCHC values.

Creatinine is a breakdown product of creatine phosphate in muscles and depends on a person’s muscle mass. Creatinine is normally produced at a fairly constant rate (approx. 1 g of creatinine is excreted per day). Therefore, the creatinine concentration can be used to interpret results of spontaneously voided urine samples, which show variable dilutions, in a more consistent way.

Crystals can take many different shapes in urine. They are formed if urine solutes – such as inorganic salts or organic compounds – precipitate. Most of the time, crystals are not significant for clinical findings unless the patient has metabolic disorders, calculus formation (also called ‘urolithiasis’), or if medication needs to be regulated. The most important crystals in this context are cystine, tyrosine, leucine and cholesterol.

Sysmex method for measuring the haematocrit (HCT). HCT is a parameter that is a measure of the total or cumulative volume of red blood cells relative to the total volume of whole blood. It is expressed as a fraction with the unit L/L or as a percentage value.

On Sysmex analysers , the HCT is obtained - by using impedance technology - from the cumulative value of the individual cell pulse heights. It is therefore directly measured and not calculated, as is the case with some other technologies.

Biomarker for the dissolution of blood clots called fibrinolysis.

Parameters individually delivering diagnostically relevant information, intended to be transmitted to clinicians and wards or affiliated physicians outside the lab/hospital.

Différenciation complète des globules blancs en cinq sous-populations principales qui apparaissent physiologiquement dans certaines concentrations dans le sang périphérique: lymphocytes, monocytes, éosinophiles, basophiles et neutrophiles. La capacité des analyseurs 5 populations à énumérer également les types de cellules les moins abondantes (monocytes, éosinophiles et basophiles) constitue une avancée notoire.

Les résultats sont exprimés en pourcentage de la numération totale des leucocytes et en numérations absolues, celles-ci étant plus riches en informations: en cas de maladie, les rapports sont déformés et par conséquent, les numérations en pourcentage n'ont aucune signification en l'absence de valeurs absolues.

La principale différence avec la technologie différentielle en 3 populations est que l'identification cellulaire repose sur une analyse tridimensionnelle et non sur la seule taille de la cellule, ce qui permet d'identifier les cellules immatures et anormales, et ainsi de cerner la cause potentielle d'une maladie chez un patient.

Les derniers analyseurs automatiques d’hématologie sont capables de classer les granulocytes immatures (IG) dans une sixième population et de les exprimer sous forme de numération en pourcentage de la numération totale des leucocytes et en une numération absolue.

Le terme de «différentiel en 6 populations» désigne généralement le différentiel classique en 5 populations et la quantification supplémentaire de granulocytes immatures (IG) constituant la sixième sous-population de leucocytes. En routine, les analyseurs des gammes XN-L et XN Sysmex rapportent la numération IG en tant que paramètre diagnostique: exprimé sous la forme d'une numération en pourcentage de la numération totale des leucocytes et en numération absolue.

Eosinophils are in the granulocytes category because they are filled with granules containing different enzymes. They can move and phagocytise (roughly ingest) particles. As they kill parasites by releasing certain cytotoxic enzymes and are involved in hypersensitivity reactions, an increased eosinophil count is most likely associated with parasite infestation or allergy. Eosinophilia can also point to malignant diseases as it is evident in some types of neoplasia.

‘Epithelium’ is a general term for cellular tissue that wraps around certain surfaces. Inside the urinary tract, there are different types of epithelial cells: the squamous (Squa. EC) and the non-squamous epithelial cells (Non SEC). The non-squamous cells are further divided into transitional (Tran. EC) and renal tubular epithelial cells (RTEC).
Squamous epithelial cells (Squa. EC) are large, flat, irregularly shaped cells. They contain a small central nucleus and lots of cytoplasm. The cell edge is often folded over and the cell may be rolled up into a cylinder. It is normal to find squamous epithelial cells in urine. They come from the lower end of the urethra or from skin that the urine came into contact with during collection. As such, they may also represent a contamination typical for poorly collected mid-stream urine samples.
Transitional epithelial cells (Tran. EC, urothelial cells) vary in size and shape depending on their origin. They can come from the upper part of the urethra, from the ureters or the renal hilum. It is normal to find low numbers of transitional cells in urine.
Renal tubular epithelial cells (RTEC) are slightly larger than leucocytes and contain a large, round nucleus. They can appear flat, cube-shaped or as a column. They enter the urine from the tubule system of the nephrons. The presence of RTEC in urine indicates kidney problems.

A common, traditional laboratory test serving as a sensitive, yet non-specific marker of inflammation. It can serve to aid diagnosis, and manage and follow-up various autoimmune diseases, acute and chronic infections and tumours. The ESR is also used as a marker of the 'general physical condition' assessed together with the patient's clinical history and physical examination.

Glycoprotein, which acts as a cofactor of factor IX in clot formation. Elevated factor VIII concentrations are associated with an increased risk of thromboembolic events.

Biomarker for the dissolution of blood clots called fibrinolysis.

Glycoprotein, which converted into fibrin by the serine protease thrombin (factor IIa) and calcium (factor IV) and forms the thrombus together with the platelets.

Sysmex's technology used inside the differential haematology analysers of the X-Class and XN-Class, by which blood cells of all three major cell lines are detected and differentiated after supravitally labelling them with proprietary fluorescence markers and exposing them in a flow cell to laser light.

The urine of a healthy person only shows trace amounts of sugar, i.e. glucose. Glucose appears in urine when the blood glucose level rises because of an abnormality of the glucose metabolism. The determination of glucose in urine has a high diagnostic value for early detection of disorders such as diabetes mellitus.

A long-term monitoring parameter used to control diabetics' medical status. It has become a frequently ordered test in medical labs nowadays because of the increase in lifestyle diseases such as diabetes. Automated HbA_1c testing is facilitated with the Tosoh HLC-723 G11 Analyser.

A category of myeloid white blood cells characterised by the presence of granules in the cytoplasm. The granulocytes comprise the neutrophils, eosinophils and basophils. They make up the group of polymorphonuclear white blood cells as opposed to the mononuclear white blood cells (lymphocytes and monocytes).

In the body fluid modes of the Sysmex XN-Series and some of the X-Class analysers, the parameter 'PMN' is reported, covering the above mentioned granulocytic cells. Together with the parameter 'MN' covering the mononuclear cells it can help get an idea of the cause of a present infection or inflammation, for instance in CSF (cerebrospinal fluid) samples.

Haemoglobin is the iron-containing red blood pigment in red blood cells that enables the transport of oxygen in the body. The detection of haemoglobin in urine is due to either elevated haemoglobin levels or the presence of red blood cells in the sample. Elevated values of this parameter are an important symptom for injuries, crystals, glomerulonephritis, renal calculi, or urinary tract infections.

Research parameter indicating the presence of highly fluorescent lymphocytes, which represent activated cells (antibody-secreting B lymphocytes/plasma cells) if systemic haematological diseases can be excluded.

Represents the activated lymphocytes given that a haematologic disease has been excluded.

Sysmex's technology used inside haematology and urinalysis analysers to optimise cell/particle counting; by means of a sheath flow, the cells or particles are separated and aligned upon entering the flow cell or detection unit to effectively prevent coinciding or recirculation of cells/particles.

Particularly RBC change shape when exposed to rapid acceleration in a suspending fluid. With HDF, the degree of acceleration is significantly reduced, therefore the true cell properties are reflected more closely.

Fluorescence flow cytometry enables the identification of immature cells on the basis that they have higher nucleic acid content in comparison with their mature counterparts. This added the count of immature granulocytes (IG) as a distinct population to the WBC differential. This IG count includes promyelocytes, myelocytes and metamyelocytes but not band cells.

The presence of IG is always pathological with the exception of the immediate post-partum period and neonates less than 3 days old. The precision of the automated IG count is much better than manual microscopy counts making it ideal for serial monitoring of patients thereby eliminating labour-intensive manual counting.

Clinical value APP optionally available on the XN-Series analysers to measure platelets, thanks to specific fluorescence labelling, with high precision and accuracy also in the thrombocytopenic range. A very good correlation with the reference method (CD41/61) has been shown.

PLT-F also determines the immature platelet fraction (IPF) reflecting thrombopoietic bone marrow activity, making it particularly useful for tracking down thrombocytopenia and its possible causes.

Software component (with hardware) that is steering/running the Sysmex analysers. With XN-Series, the IPU offers a range of standard applications for the 'analysis' step. They can be interwoven with the Extended IPU applications for advanced functionalities.

Sysmex laboratory solutions are controlled intelligently by the embedded software concept. This harmonises and standardises the interplay between the physical sample and data workflow. From a single system to multiple work areas, even if your network spans multiple locations.
However, apart from software, we offer also much more including Caresphere Academy services, digital training and onsite educational workshops and consultancy services.

Ketones in urine indicate increased fat degradation in the body. This can be caused by an insufficient supply of energy from carbohydrates. During the degradation of fatty acids, intermediary compounds called ‘ketone bodies’ (acetoacetic acid, s-hydroxybutyric acid and acetone) are formed in the liver. Ketones can be detected in urine when increased fat degradation takes place and is particularly important in checking metabolic decompensation in diabetes mellitus.

Leucocyte esterase is an enzyme produced in white blood cells – to be more precise, in granulocytes. Detection of leucocyte esterase reveals the presence of granulocytic leucocytes. Elevated values of this parameter are an important symptom for inflammatory diseases of the efferent urinary tract and kidneys.

Lymphocytes originate from the lymphoid lineage (as opposed to the myeloid lineage). Lymphoid cell development is not restricted to the bone marrow and takes place in primary and secondary lymphoid organs.

Lymphocytes defend the organism against infection by distinguishing the body’s own cells from foreign ones. Molecules recognised by the body as foreign are known as antigens. Each lymphocyte is only stimulated by one specific antigen. When lymphocytes recognise this antigen, they produce chemicals to fight it.

There are three main types of lymphocytes: B lymphocytes, T lymphocytes and natural killer (NK) cells. Lymphocytes belong to the mononuclear white blood cells. Although compared to other white blood cells all lymphocytes are small and round without granules, there is a large variety of different subtypes, and distinguishing between them morphologically is tricky.

Reasons for an increased lymphocyte count include infection or inflammation, as well as certain types of malignancies, especially haematological malignancies. Despite giving an absolute and relative lymphocyte count, several flags on Sysmex analysers can point to suspicious lymphocytes for which, if present, a follow-up test should be performed.

The average amount of haemoglobin per red cell is calculated from the RBC and HGB. MCH [pg] = HGB/RBC. The normal reference range for MCH is age-dependent. The MCH value tends to be proportional to MCV as the size of a cell is largely determined by the haemoglobin content.

Cells that have a normal MCH are referred to as normochromic whereas those with low and high values are termed hypochromic and hyperchromic. A low MCH indicates that cells contain too little HGB due to inadequate production. Such cells are termed hypochromic as they will look pale when examined under the microscope.

The mean cell haemoglobin concentration is calculated from HCT and HGB and reflects the proportion of amount of HGB in the red cell to the cell volume. MCHC [g/dL] = HGB/HCT. The MCHC normal reference range is remarkably constant throughout life and generally has a very tight range with minimal variation expected.

The MCHC is also used to define normo-, hypo- and hyperchromic red cell populations. Cells with too little HGB concentration are lighter in colour and have a low MCHC. An elevated MCHC for clinical reasons is rare and virtually only occurs if cells are spherocytic (due to loss of membrane) or significantly dehydrated. These hyperchromic red cells show an unusually high intracellular HGB concentration per individual red cell due to cell volume loss.

The MCHC is commonly used to monitor the technical performance of an analyser.

Brand name of the methanol-free staining reagents manufactured by company RAL Diagnostics, used inside the RAL Stainer and the RAL semi-automated staining device to stain blood films.

Monocytes belong to the mononuclear cells like lymphocytes do, but they originate from the myeloid lineage, which cells are produced in the bone marrow.

Monocytes play a key role in the immune response. They can quickly move to infection sites and differentiate into macrophages and dendritic cells to provoke an immune response. Cells of the monocyte-macrophage system can engulf foreign particles and break them down to antigens, which they can then present at their surface.

Automated monocyte counts are available as the ratio of monocytes to the total number of white blood cells counted or as an absolute count. An increased monocyte count may be indicative of various disease states, e.g. chronic inflammation or infection, but it may also occur in malignant diseases such as chronic myelomonocytic leukaemia.

MWO embedded in the Extended IPU offers a concept to distinguish reactive monocytosis from monocytosis of suspected malignant origin. The MWO concept helps to decrease the number of unnecessary blood smear reviews while optimising the detection of CMML and ultimately improving the laboratory workflow.

Indicates an early immune response by quantifying/measuring the activation of neutrophils

Neutrophils belong to the category of granulocytes. They play an important role in immune defense
and are the first immune cells to arrive at a site of infection – usually within an hour. This happens through a process known as chemotaxis.
Neutrophils can phagocytise other cells such as bacteria, which seem harmful to the organism. Yet they will not survive the act themselves. Pus consists mainly of dead neutrophils and digested bacteria.

The absolute and relative neutrophil count can provide some information for diagnosis and monitoring of infections and is also taken into account during chemotherapy.

An increased neutrophil count can also be found physiologically in non-pathological situations, e.g. after stress or in smokers.

Nitrite is the result of nitrate reduction. Various bacteria that cause urinary tract infections (UTI) produce enzymes that turn nitrate into nitrite. The presence of nitrite in urine is an indirect confirmation of bacterial infection (bacteriuria). Common microorganisms that can cause urinary tract infections, such as Escherichia coli, Enterobacter, Citrobacter, Klebsiella, and Proteus species, produce enzymes that reduce urinary nitrate to nitrite.
A negative NIT test strip result does not exclude a urinary tract infection because there could be bacteria present which do not produce nitrite. Therefore, nitrite is specific but not sensitive for UTI. Furthermore, with strong bacterial growth, nitrite may eventually be degraded to nitrogen, which means that remaining nitrite levels in the sample may be below the limit of detection.

Sysmex have created a new diagnostic dimension with the OSNA molecular diagnostic assay.
In contrast to the conventional methods of imprintcytology and frozen section the OSNA system enables the analysis of the complete lymph node and therefore a final intraoperative decision in an adequate intraoperative time-frame.

Fibrinolytic marker. 

Proenzyme of plasmin, the key enzyme in fibrinolysis.

PAI-1 is a serine protease inhibitor that functions as the principal inhibitor of tissue plasminogen activator (tPA) and urokinase (uPA), the activators of plasminogen.

Platelets parameter, which is equivalent (by meaning) to haematocrit, but calculated from MPV and PLT count (PCT = MPV x PLT).

A group of compounds used (besides their widespread industrial use) for supravital cell labelling as fluorochrome markers, together with a semi-conductor laser as light source, in Sysmex's haematology and urinalysis devices (Sysmex-proprietary use).

There are several advantages of these compounds: Their absorption maximum can be tailored to the exact laser wavelength, their cell and nucleus permeability can be customised, and the affinity to specific cell components, such as nucleic acids, can be generated as necessary – through changes in the molecular structure. Polymethines show an excellent signal-to-noise ratio, are broken down easily in aqueous waste, and in terms of mutagenicity, they are described as safe compared to other nucleic acid-bonding fluorochromes.

In Sysmex's X-Class and XN-Series analysers, several different polymethine-containing reagents are used for specific differentiation analysis of mature and immature cells of all three cell lines.

Most proteins are normally contained in blood because they are too large to fit through the glomerular membrane. However, if these filters are damaged, proteinuria – the presence of protein in urine – can occur. Protein in urine is a frequent symptom of renal diseases, but it is not very specific. Protein levels in urine can be temporarily increased due to exercise, fever or stress.

Describes the presence of protrein in urine.

Global parameter to monitor the so-called extrinsic coagulation factors and treatment with vitamin-K antagonists.

Identifies the presence of activated CD4+ and CD8+ T lymphocytes [Rutkowska et al. 2021]

Quantitative assessment of the number of reactive monocytes present in infections

Red blood cells deliver oxygen to the body’s tissues by travelling through the circulatory system. They are round, smooth and have a red tinge. If red blood cells appear in this intact shape, they are called isomorphic or eumorphic and do not come from the glomerulus. If red blood cells become damaged, they are called dysmorphic red blood cells. Their deformation occurs when they pass through the glomerular structures of the kidney, but it can also happen when they are exposed to urine for a prolonged time. The term for pathological dysmorphic red blood cells is ‘acanthocytes’. Their presence can indicate a glomerular disease such as glomerulonephritis.
If there are a few red blood cells in urine, this can be considered normal. A high number of red blood cells, however, can indicate the presence of injuries, crystals, renal calculi or urinary tract infections.

An automated parameter providing information on the degree of variation of red blood cell (RBC) size: It is a quantitative measure of how variable the size of the individual red cells is. This is provided as an RDW-SD and an RDW-CV value.

A large RDW indicates abnormal variance in individual RBC size, termed anisocytosis, when viewed under the microscope. The RDW assists in the differentiation of anaemias that have similar red cell indices.

Clinical value APP optionally available on the XN-Series analysers to quantify and differentiate reticulocytes according to their maturity stages (HFR, MFR, LFR) thanks to specific fluorescence labelling. An optical platelet count (PLT-O) can also be provided.

RET also determines the immature reticulocyte fraction (IRF=HFR+MFR) and the reticulocyte haemoglobin equivalent (RET-He), assessing both the quantity (erythropoietic activity) and the quality (haemoglobin synthesis and incorporation) of the newly formed red cells. This is important with anaemia differential diagnostics. RET-He is also an early indicator for changes in the red cell haemoglobinisation, which is helpful e. g. in therapy monitoring.

The RPI reflects the erythropoietic bone marrow response in anaemic patients. This index, rather than merely the RET count alone, is used to assess the adequacy of the bone marrow response to anaemia in patients. It is not useful in the absence of anaemia.

RPI is defined as follows: RPI = (RET% × HCT) : (0.45 × days in blood). 0.45 represents the ideal haematocrit in the formula. At this 'ideal' HCT of 0.45, RPI is identical to the reticulocyte percentage, which is 'ideally' about 1% in normal healthy individuals. In an anaemic patient with adequate bone marrow response, the RPI should be > 2.0. However, the reverse conclusion (if RPI is < 2.0, the bone marrow response is considered inadequate) is not necessarily true.

A good marker of appropriate bone marrow response to anaemia is the increase of the absolute reticulocyte concentration, together with a marked increase of the immature reticulocyte fraction (IRF).

Function allowing immediate measurements of individual, urgent samples.

Sysmex's design concept that contributes to a more enjoyable workplace experience by putting people first and optimising the interaction between the individual and the devices they use day in, day out.

Within our SILENT DESIGN® concept, we are focusing on five main principles to continuously improve the user experience: person - space - surface - series - longevity. Our SILENT DESIGN® products take into account all five principles to create a positive experience.

Sysmex's cyanide-free measuring method for HGB, which delivers particularly reliable results thanks to the effective lysis of RBC, WBC and lipids, leading to a reduction in potential interferences.

Urinary specific gravity is based on the concentration of solutes in urine. It measures the ratio of urine density compared to water and provides information on the kidney’s ability to concentrate urine. If the specific gravity values drop below 1.010 g/mL urine, cells undergo faster lysis than in normal conditions (1.010 to 1.030 g/mL).

Dedicated articles on clinical and diagnostic background topics with a scientific and educational focus. Topics include e.g. coagulation, haematology, urinalysis, body fluids, etc.

Used to detect increased intravascular thrombin formation. Elevated values in DIC, postoperatively, after trauma, in thromboembolic diseases, atherosclerosis and difficult blood collection.

Protein that acts as a transmembrane receptor for thrombin in endothelial cells and increases the ability of thrombin to activate protein C by a thousandfold.

TWO streamlines the entire platelet analysis workflow in the laboratory as it optimises the triggering of PLT-F reflex tests and supports the differential diagnosis of thrombocytopenic patients and their monitoring. 

The new TWO algorithm is embedded in the Extended IPU and can be used in conjunction with the PLT-F application.

Sysmex's technology used inside the urinalysis analysers of the UX- and UF-series, by which urinary cells and particles are detected and classified after labelling them with proprietary fluorescence markers and exposing them in a flow cell to laser light.

Urobilinogen is a colourless by-product of bilirubin reduction. It is excreted in increased amounts in urine when the functional capacity of the liver is impaired or overloaded, or when the liver is bypassed. However, a value of zero is also critical since this may indicate biliary obstruction.

Carrier protein of blood coagulation factor VIII. Binds to collagen and platelets after vessel wall damage.

White blood cell pathologies may affect either the myeloid or the lymphoid lineage. They can be the result of both reactive and non-reactive (neoplastic or malignant) disease. Reactive changes are observed in the course of infectious or inflammatory diseases whereas malignant alterations point to leucaemias, lymphomas and other haematological malignancies.

To distinguish between different diseases related to white blood cells, determining both their number and their exact type and maturity status is crucial. Automated haematology analysis is a vital component in the diagnostic process and helps identify the presence of disease by providing accurate cell counts and by highlighting conspicuous cell populations. In white blood cell diseases, finding the right diagnosis is complex and needs to consider all the information available from the complete and differential blood count, morphology, immune phenotyping, and other tests.

White blood cells, also called leucocytes, are vital parts of the immune system. They help protect the body against infections and foreign invaders.

WBC are round and, if they are granulocytes, granulated. They measure approximately 1.5 to 2 times the diameter of a red blood cell. In urine, the most common type of WBC are neutrophils (i.e. neutrophilic granulocytes), whereas lymphocytes or eosinophils (eosinophilic granulocytes) are rare findings in urine.

A small number of WBC can be present in healthy urine but increased counts can point towards inflammation or infection within the urinary system.

A group of Sysmex automated haematology analysers consisting of different XS-series models, all based on fluorescence flow cytometry technology and delivering a 5-part blood differential plus a varying array of extended parameters offering further diagnostic possibilities.

Clinical value APP available as standard on the XN-Series analysers for the complete blood cell count analysis.

Added value over the standard CBC is given through the counting of nucleated red blood cells (NRBC) as a distinct population, which can be important in recognising critical developments in ICU patients, and which also means the WBC count values are not affected by the presence of NRBC, e.g. in neonates, where their concentrations are relatively high. This eliminates the need for manual NRBC counting, speeds up turnaround time and advances standardisation.

Yeast cells are smooth, colourless and usually egg-shaped. They have birefringent walls, come in different sizes and often show budding. The most common type of yeast found in urine is Candida albicans. Yeast cells in urine can come from either skin-related or vaginal contaminations or can indicate mycotic urinary tract infections.