of basophils, >500 NA /[micro]L Basophil, % NA >4 Reticulocyte Absolute reticulocyte, >0.100 NA x [10.sup.3]/[micro]L Suspect flags Nucleated red Flag Flag blood cell Blast Flag Flag Atypical lymphocyte Flag Flag RBC fragment Flag NA Dimorphic RBC Flag NA Lyse resistant Flag NA Immature granulocyte
Flag NA Left shift Flag NA PLT clump Flag NA Platelet (except Flag NA PLT clump) Suspect flag (except Flag NA ImmG/band in adult) Suspect flag (child) Flag NA Abbreviations: CBC, complete blood count; HGB, hemoglobin; ImmG, immature granulocyte
; MCV, mean corpuscular volume; NA, not available; PLT, platelet; RDW, red cell distribution width; WBC, white blood cell; RBC, red blood cell.
(1) From the idea that sepsis always begins with an infection, additional guidelines for diagnosing sepsis have focused on the immune system's response to an infection, and in particular, a rise in the immature granulocyte
(IG) percentage in patients with a normal total WBC count.
(4) For example, the ADVIA 2120i displays immature granulocyte
flags by comparing parameters from the peroxidase and the basophil/lobularity chambers, whereas the XE 2100 uses the IMI channel to enumerate immature granulocytes
Among these, the immature granulocyte
(IG) parameter in peripheral blood has recently gained considerable interest.
In hematology, we will continue to automate and drive precise results, such as with our expanded CBC including immature granulocyte
(IG) analysis, immature platelet fraction (IPF), and reticulocyte hemoglobin (RET-He).
(6,7) An upgraded software package (XE-IG Master, Sysmex) allows users to obtain an extended differential WBC count with the addition of an immature granulocyte
count, consisting of promyelocytes, myelocytes, and metamyelocytes, to the standard 5-part differential test.
We can anticipate that vendors will introduce improved algorithms, detection systems, and reagents to improve blast, immature granulocyte
, and NRBC detection, which will further improve FPE.
Evaluation of Immature Granulocyte
Counts by the XE-IG Master: Upgraded Software fortheXE-2100 Automated Hematology Analyzer.
Instruments are able to give percent and absolute counts of immature granulocyte
populations such as metamyelocytes, myelocytes, and promyelocytes.
Features include advanced clinical parameters such as the immature granulocyte
(IG) and reticulocyte hemoglobin (RET-He) parameters.
What about other reportable FDA-cleared parameters, such as immature granulocyte
enumeration, or IG, and immature platelet fraction, or IPF?
Currently, there is a move to have the "left-shift" cells grouped into an immature granulocyte