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Automated blood cell differential: State of the art and eye to the future 1

Abstract Complete blood count including automated blood cell differential is one of the most frequent tests in the medical laboratory. How reliable is the method representing a diagnostic sieve in a stepwise diagnostic approach? Which pathologic conditions will be overlooked? Which body fluids can be investigated? What are the preanalytical requirements? When is a microscopic review required? Reimbursement has reached a level where a personal review of the diagram of cell clusters and of the blood film cannot be afforded. As the technology of blood cell analyzers has recently been described in this journal, this article focuses on the strengths and weaknesses of the automated blood cell differential. This allows judgment of the risks of a stepwise approach dependent on the medical discipline sending the sample.