Manual Differential
CPT Code(s):
85004
Turnaround Time:
8 hours
Specimen Requirements
Preferred Specimen:
Whole Blood
Minimum Volume:
1.0 mL
Transport Container:
Lavender Top Tube
Transport Temperature:
Room Temperature
Collection Instructions:
Whole blood collected in lavender EDTA tube; inverted several times to mix blood with anticoagulant.
Rejection Criteria:
Hemolysis; clotted specimen; specimen drawn in any anticoagulant other than EDTA; specimen diluted or contaminated with IV fluid; tube not filled with minimum volume; improper labeling; transfer tubes with whole blood; specimen received with plasma removed (plasma is used for other testing)
Stability Criteria
Room Temperature:
24 hours
Refrigerated:
48 hours
Frozen:
Unacceptable
Clinical Significance
Manual Differential holds specific clinical significance and diagnostic use in evaluating the different types of white blood cells (WBCs) present in a patient's blood sample. It is performed by a trained laboratory professional who visually examines and classifies the different types of WBCs under a microscope.
The specific clinical significance and diagnostic use of Manual Differential include:
1. Identification of Abnormal Cell Types: Manual Differential allows for the identification of abnormal or immature cell types that may not be accurately classified by automated cell counters. This can be important in diagnosing and monitoring certain hematological disorders, such as leukemia or other blood cell disorders.
2. Assessment of Infection or Inflammation: Changes in the distribution and proportions of different types of WBCs can provide valuable insights into the presence and nature of infection or inflammation. Elevated neutrophils may indicate bacterial infections, while increased eosinophils may suggest allergic or parasitic conditions. Lymphocytosis may be observed in viral infections, and monocytosis may be associated with chronic inflammatory conditions.
3. Evaluation of Bone Marrow Function: Manual Differential aids in assessing bone marrow function and evaluating the production of different types of blood cells. It can provide information about the overall health of the bone marrow and detect any abnormalities in cell production or maturation.
4. Monitoring Treatment Response: Serial Manual Differential tests may be performed to monitor the response to specific treatments. Changes in the distribution and proportions of different types of WBCs can help assess the effectiveness of therapy and guide further management.
5. Diagnosis and Management of Hematological Disorders: Manual Differential is an essential tool in diagnosing and managing various hematological disorders, such as leukemias, lymphomas, and autoimmune diseases. It provides additional information beyond the automated complete blood count (CBC) and allows for a more comprehensive assessment of the patient's hematological status.
Interpretation of Manual Differential results requires expertise and experience in hematological analysis. It involves evaluating the relative proportions of different types of WBCs, identifying any abnormal cell morphology, and considering the patient's clinical history and other laboratory findings.
In summary, Manual Differential is specifically used for identifying abnormal cell types, assessing infection or inflammation, evaluating bone marrow function, monitoring treatment response, and diagnosing and managing various hematological disorders. It provides valuable information about the different types of WBCs, aiding healthcare providers in diagnosing and monitoring hematological conditions. Close collaboration between laboratory professionals and healthcare providers is crucial to interpret the test results accurately and guide appropriate patient management.