Arneth Count: Principle, Procedure, & Result

what is arneth count?

The Arneth count assesses the distribution of neutrophils based on the number of lobes in their nuclei, categorizing them into groups with one, two, three, four, and five or more lobes. This method provides valuable information about the morphology of neutrophils, aiding in the identification of potential health issues.

The percentage of neutrophils in each lobe category offers insights into the overall health and functioning of the immune system. This straightforward classification helps healthcare professionals in diagnosing and monitoring various medical conditions.

Arneth count, The neutrophilic polymorphonuclear leukocyte develops from a mononuclear cell with a single round nucleus. The mononuclear cell passes through an intermediate stage with a single indented nucleus. (metamyelocyte), but not true nuclear. Arneth count was discovered by Joseph Arneth in 1903. He divided these cells into five classes

STAGESNUCLEAR LOBENORMAL RANGE
1. STAGE 1 (N1)CONTAINING CELL WITH ONE NUCLEAR5-10 %
2. STAGE 2 (N2)CONTAINING CELL WITH TWO NUCLEAR30-35 %
3. STAGE 3 (N3)CONTAINING CELL WITH THREE NUCLEAR40-45 %
4. STAGE 4 (N4)CONTAINING CELL WITH FOUR NUCLEAR15-20 %
5. STAGE 5 (N5)CONTAINS CELL WITH THREE NUCLEAR2-4 %

principle of arneth count

The principle of the Arneth count involves categorizing neutrophils into different groups based on the number of lobes present in their nuclei. Typically, younger neutrophils have fewer lobes, while older ones exhibit more lobes. The count determines the percentage of neutrophils with one, two, three, four, and five or more lobes, offering insights into the overall composition of the neutrophil population.

Each class has a subdivision according to the shape of the nuclear portion whether round or s- shape making twenty-five types in all. Arneth counted one hundred polymorphonuclear cells are arranged them in his five classes.

Arneth stated that the percentage of cells in the various classes varied only within the normal limits in health, but changed in infectious conditions, the change usually being in the direction of an increase in the percentage of classes 1 and 2 and a decrease in classes 3, 4 and 5: this he spoke of technically as a shift to the left.

Particular emphasis was laid on the prognostic value of this classification in pulmonary tuberculosis. Arneth’s classification did not define when a nucleus might be considered divided and so allowed the personal factor to assert itself unduly. To rectify this Cooke (1914) has given a criterion of nuclear lobulation?

If there is any band of nuclear tissue except a chromatin filament connecting the different parts of a nucleus, the nucleus cannot for the Arneth count be said to be divided; When the count is made according to Cooke’s method the average normal figures vary considerably from those obtained with Arneth’s method. Cooke (1914 and 1928) gives the following figures as the average normal:-

STAGESNUCLEAR LOBENORMAL RANGE
1. STAGE 1 (N1)CONTAINING CELL WITH ONE NUCLEAR10 %
2. STAGE 2 (N2)CONTAINING CELL WITH TWO NUCLEAR25 %
3. STAGE 3 (N3)CONTAINING CELL WITH THREE NUCLEAR47 %
4. STAGE 4 (N4)CONTAINING CELL WITH FOUR NUCLEAR16 %
5. STAGE 5 (N5)CONTAINS CELL WITH THREE NUCLEAR2%

Schilling (1920) simplified Arneth’s classification by dividing the neutrophilic cells into the following four groups:-

  1. GROUP 1
  2. GROUP 2
  3. GROUP 3
  4. GROUP 4

1. GROUP 1

Group 1 is known as myelocytes.

2. Group 2

Young metamyelocytes (with only the slightest indentation) of the nucleus.

3. GROUP 3

Older metamyelocytes (with deep indentation but no true lobulation of the nucleus).

4. GROUP 4

Group 4 is known as the polymorphonuclears

the procedure of arneth count

  • Blood smear preparation
  • Staining
  • Microscopic Examination
  • Classification
  • Counting
  • Analysis

For the Arneth count clean slides and thin well-stained films are mandatory. The slides should be put in sulphuric acid overnight and washed well in running water for four hours or longer to remove all traces of the acid. They are next washed in distilled water and then in alcohol and stored in absolute alcohol. At the time of using the slide is thoroughly dried with a piece of clean linen.

Leishman’s and Jenner’s stains are not satisfactory for the nuclei are poorly stained and the granules of the cytoplasm are too prominent.

Giemsa or Wright’s stains are quite satisfactory, but the stains that are strongly recommended and which we have found very satisfactory are hematoxylin and eosin. This stains the nuclear structure very clearly whilst the neutrophilic granules are not stained.

  • The smear is fixed in methyl alcohol and stained with Delafield’s hematoxylin solution for 3 to 5 minutes.
  • The slide is thoroughly rinsed in water, and a counter-stain is applied using a 0.5 percent eosin solution for approximately one minute.
  • The slide is once more rinsed, dried, and then examined.

result of arneth count

In counting the number of nuclei in each cell Cooke’s criterion should be kept in mind and the nuclear parts joined by more than a thread should be considered as one. Some experience is required to make the count because sometimes the lobes are lying in such a way that, although they may be separate, the whole looks like one convoluted lobe.

Arneth gives the following figures as a normal count :

STAGESNUCLEAR LOBENORMAL RANGE
1. STAGE 1 (N1)CONTAINING CELL WITH ONE NUCLEAR5 %
2. STAGE 2 (N2)CONTAINING CELL WITH TWO NUCLEAR35 %
3. STAGE 3 (N3)CONTAINING CELL WITH THREE NUCLEAR41 %
4. STAGE 4 (N4)CONTAINING CELL WITH FOUR NUCLEAR17%
5. STAGE 5 (N5)CONTAINS CELL WITH THREE NUCLEAR2%

If Cooke’s criterion is adopted the normal reads as follows :

STAGESNUCLEAR LOBENORMAL RANGE
1. STAGE 1 (N1)CONTAINING CELL WITH ONE NUCLEAR10 %
2. STAGE 2 (N2)CONTAINING CELL WITH TWO NUCLEAR25 %
3. STAGE 3 (N3)CONTAINING CELL WITH THREE NUCLEAR47%
4. STAGE 4 (N4)CONTAINING CELL WITH FOUR NUCLEAR16%
5. STAGE 5 (N5)CONTAINS CELL WITH THREE NUCLEAR2%

What is the Arneth Count?

The Arneth Count is a method in hematology used to classify and differentiate white blood cells, specifically neutrophils, based on the number of nuclear lobes present.

What are neutrophils and why are they important?

Neutrophils are a type of white blood cell that plays a crucial role in the immune system, defending the body against bacterial and fungal infections. The Arneth Count focuses on the classification of neutrophils.

How does the Arneth Count categorize neutrophils?

Neutrophils are classified into five stages (bands and segmented neutrophils) based on the number of nuclear lobes. Stages range from 1 to 5, with 1 being the least mature and 5 being the most mature.

What information does the Arneth Count provide?

The Arneth Count offers insights into the maturation stages of neutrophils, aiding in the assessment of a patient’s overall health and helping identify potential underlying conditions.

Is the Arneth Count still commonly used in modern medicine?

No, the Arneth Count has largely been replaced by automated hematology analyzers. These modern systems provide more accurate and efficient blood cell analysis without the need for manual classification.

Why has automated cell counting become more prevalent?

Automated cell counters offer quicker and more accurate results, processing a large number of samples in a short time. They also reduce the potential for human error associated with manual methods.

What are the limitations of the Arneth Count?

The Arneth Count is a manual method and is time-consuming. It may also be less precise compared to automated systems, and its use has diminished with the advent of advanced technologies.

How can healthcare professionals stay updated on the latest hematology practices?

Healthcare professionals can stay informed through continuous education, attending conferences, and keeping abreast of advancements in hematology technology and research.

Is the Arneth Count still taught in medical education?

While it may be mentioned for historical context, modern medical education focuses more on automated methods and advanced technologies in hematology.

What are the alternatives to the Arneth Count in contemporary hematology?

Contemporary hematology relies on automated cell counters, flow cytometry, molecular diagnostics, and other advanced technologies for comprehensive and precise blood cell analysis.

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