Clinical reference values for cerebrospinal fluid white blood cell counts analyzed using the automated hematology analyzer XE-5000 in children

Abstract

In our hospital, the counts of cerebrospinal fluid (CSF) white blood cells (WBCs) have been analyzed using the automated hematology analyzer Sysmex XE-5000. However, the reference values based on the manual counting method are still being used. The objective of this study was to estimate the clinical reference values for CSF WBC counts in children measured using the XE5000. This study included CSF analysis data that were analyzed using the XE5000 in Gunma Children’s Medical Center between June 1, 2009 and December 31, 2018. These data were collected from electronic medical records and were excluded sequentially if conditions known or suspected to cause CSF pleocytosis were present (e.g., meningitis and leukemia). Data for a total of 785 children were included, and they were divided into four groups according to age. The reference values were calculated using MCP-STAT Ver. 6 (Sysmex Corporation). The estimated clinical reference values were as follows according to age: 0 to 27 days after birth, 30/μL; 28 days to less than 1 year old, 13/μL; 1 to 5 years old, 8/μL; 6 to 15 years old, 3/μL. These values were higher than the reference values based on the manual counting method except for the age group 6 to 15 years. When the CSF WBC count is evaluated by automatic analysis, it is necessary to consider a reference value suitable for a hematology analyzers used.