Detection of the Plasmodium falciparumAntigen Histidine-Rich Protein 2 in Blood of Pregnant Women: Implications for Diagnosing Placental Malaria

Pregnant women have an increased susceptibility to infection byPlasmodium falciparum. Parasites may be present in the placenta yet not detectable in peripheral blood smears by routine light microscopy. In order to determine how frequently misdiagnosis occurs, peripheral blood and placental samples were collected from 1,077 Cameroonian women at the time of giving birth and examined for the presence of malarial parasites by using light microscopy. Results showed that 20.1% of the women who had placental malaria were peripheral blood smear negative. Thus, malarial infection was not detected by microscopic examination of peripheral blood smears from approximately one out of five malaria-infected women. Since P. falciparum parasites secrete histidine-rich protein 2 (HRP-2), we sought to determine if detecting HRP-2 in either peripheral plasma or whole blood might be used to diagnose the presence of parasites “hidden” in the placenta. Samples of peripheral plasma from 127 women with different levels of placental malarial infection were assayed by HRP-2-specific enzyme-linked immunosorbent assay. HRP-2 was detected in 88% of the women with placental malaria who tested negative by blood smear. Additionally, whole blood was obtained from 181 women and tested for HRP-2 with a rapid, chromatographic strip test (ICT). The ICT test accurately detected malarial infection in 89.1% ofP. falciparum-infected women. Furthermore, 94% of women with malaria were accurately diagnosed by using a combination of microscopy and the ICT test. Thus, detection of HRP-2 in conjunction with microscopy should improve diagnosis of malaria in pregnant women.

Download Full-text

Prevalence of Congenital Malaria in Minna, North Central Nigeria

Journal of Tropical Medicine ◽

10.1155/2012/274142 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Innocent Chukwuemeka James Omalu ◽

Charles Mgbemena ◽

Amaka Mgbemena ◽

Victoria Ayanwale ◽

Israel Kayode Olayemi ◽

...

Keyword(s):

Pregnant Women ◽

Peripheral Blood ◽

Placental Malaria ◽

Staining Technique ◽

Malaria Parasitaemia ◽

Malaria Parasites ◽

North Central ◽

Blood Smears ◽

Peripheral Blood Smears ◽

Congenital Malaria

The study was designed to determine the true prevalence of congenital, cord, and placental malaria in General Hospital Minna, North Central Nigeria. Peripheral blood smears of near-term pregnant women, as well as the placental, cord, and peripheral blood smears of their newborn babies, were examined for malaria parasites, using the Giemsa staining technique. Out of 152 pregnant women screened, 21 (13.82%) of them were infected with malaria parasites. Of the 152 new born babies, 4 (2.63%) showed positive peripheral parasitaemia. Placental parasitaemia was 7/152 (4.61%), while cord blood parasitaemia was 9/152 (5.92%). There were strong associations between peripheral and cord malaria parasitaemia and congenital malaria (P<0.05).Plasmodium falciparumoccurred in all, and none had mixed infection. The average birth weights of the babies delivered of nonmalarious pregnant women were higher than those delivered by malarious pregnant women, though not significant (P>0.05). Malaria parasitaemia occurred more frequently in primigravidae than multigravidae.

Download Full-text

Hypergranular promyelocytic leukemia (APL): cytogenetic and ultrastructural specificity

Blood ◽

10.1182/blood.v52.2.272.272 ◽

1978 ◽

Vol 52 (2) ◽

pp. 272-280 ◽

Cited By ~ 46

Author(s):

JR Testa ◽

HM Golomb ◽

JD Rowley ◽

JW Vardiman ◽

DL Jr Sweet

Keyword(s):

Bone Marrow ◽

Light Microscopy ◽

Peripheral Blood ◽

Promyelocytic Leukemia ◽

Ultrastructural Evidence ◽

Transmission Electron ◽

Blood Smears ◽

Cytogenetic Analyses ◽

Peripheral Blood Smears ◽

Ultrastructural Findings

Abstract Cytogenetic and ultrastructural findings were important diagnostic indicators of hypergranular promyelocytic leukemia (APL) in a patient whose bone marrow morphology appeared, by light microscopy, to be similar to that in acute myeloblastic leukemia (AML) with maturation. Peripheral blood smears and bone marrow specimens examined by light microscopy showed few cells with the numerous coarse, azurophilic granules typical of APL. Cytogenetic analyses, with several banding techniques, of cells from bone marrow and unstimulated peripheral blood revealed the 15;17 translocation, which has been observed only in APL. A reinterpretation of the reciprocal translocation, based on R banding, suggests that the breakpoints are distal to q24 in No. 15 and at or near the junction of q21 and q22 in No. 17. In addition, the patient had disseminated intravascular coagulation. The characteristic morphology of granules seen in APL was observed in this case only when transmission electron microscopy was used, since the granules were quite small. Since treatment for AML differs from that for APL, identification of the 15;17 translocation and ultrastructural evidence of granules represent valuable diagnostic aids for APL.

Download Full-text

Clinician-ordered peripheral blood smears have low reimbursement and variable clinical value: a three-institution study, with suggestions for operational efficiency

Diagnostic Pathology ◽

10.1186/s13000-020-01033-8 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Amy K. Beckman ◽

Valerie L. Ng ◽

David L. Jaye ◽

Manila Gaddh ◽

Sarah A. Williams ◽

...

Keyword(s):

Blood Cell ◽

White Blood Cell ◽

Peripheral Blood ◽

Blood Smear ◽

Complete Blood Count ◽

Clinical Value ◽

Laboratory Staff ◽

Clinical Scenarios ◽

Blood Smears ◽

Peripheral Blood Smears

Abstract Background Peripheral blood smears are performed to evaluate a variety of hematologic and non-hematologic disorders. At the authors’ institutions, clinician requests for pathologist-performed blood smear reviews have increased in recent years. Blood smears may contribute significantly to pathologists’ workloads, yet their clinical value is variable, and professional reimbursement rates are low. This study aimed to identify clinical scenarios in which smear review is likely to provide value beyond automated laboratory testing. Methods Blood smear review practices at three institutions were examined, and the indications for and interpretations of clinician-initiated smears were reviewed to determine the percentage of smears with potential added clinical value. A smear review was classified as having added clinical value if the pathologist’s interpretation included a morphologic abnormality that had the potential to impact patient management, and that could not be diagnosed by automated complete blood count with white blood cell differential or automated iron studies alone. Results Among 515 consecutive clinician-requested smears performed during the study timeframes, 23% yielded interpretations with potential added clinical value. When sorted by indication, 25, 19, and 13% of smear reviews requested for white blood cell abnormalities, red blood cell abnormalities, and platelet abnormalities, respectively, had findings with potential added clinical value. The proportion of smears with potential clinical value differed significantly across these three categories (p = 0.0375). Conclusions Smear review ordering practices across three institutions resulted in a minority of smears with potential added clinical value. The likelihood of value varied according to the indication for which the smear was requested. Given this, efforts to improve the utilization and efficiency of smear review are worthwhile. Solutions are discussed, including engaging laboratory staff, educating clinicians, and modifying technology systems.

Download Full-text

Rapid and Definitive Diagnosis of Infectious Diseases Using Peripheral Blood Smears

Journal of Intensive Care Medicine ◽

10.1177/088506669200700105 ◽

1992 ◽

Vol 7 (1) ◽

pp. 36-47 ◽

Cited By ~ 5

Author(s):

Lisa Soleymani Lehmann ◽

Jerry L. Spivak

Keyword(s):

Septic Shock ◽

Peripheral Blood ◽

Blood Smear ◽

Peripheral Blood Smear ◽

Rapid Diagnosis ◽

Definitive Diagnosis ◽

Parasitic Infections ◽

Blood Smears ◽

Peripheral Blood Smears ◽

Time Of Admission

A timely diagnosis is essential in the management of septicemia and septic shock. Three patients are described, all of whom presented with fever and one of whom was hypotensive at the time of admission. In each patient, rapid diagnosis of the cause of fever was possible because microorganisms were identified on a peripheral blood smear obtained at the time of admission. This identification permitted prompt initiation of appropriate antimicrobial therapy. In addition, a literature review of use of peripheral blood smears in the diagnosis of bacterial, fungal, and parasitic infections is provided.

Download Full-text

Hypergranular promyelocytic leukemia (APL): cytogenetic and ultrastructural specificity

Blood ◽

10.1182/blood.v52.2.272.bloodjournal522272 ◽

1978 ◽

Vol 52 (2) ◽

pp. 272-280

Author(s):

JR Testa ◽

HM Golomb ◽

JD Rowley ◽

JW Vardiman ◽

DL Jr Sweet

Keyword(s):

Bone Marrow ◽

Light Microscopy ◽

Peripheral Blood ◽

Promyelocytic Leukemia ◽

Ultrastructural Evidence ◽

Transmission Electron ◽

Blood Smears ◽

Cytogenetic Analyses ◽

Peripheral Blood Smears ◽

Ultrastructural Findings

Cytogenetic and ultrastructural findings were important diagnostic indicators of hypergranular promyelocytic leukemia (APL) in a patient whose bone marrow morphology appeared, by light microscopy, to be similar to that in acute myeloblastic leukemia (AML) with maturation. Peripheral blood smears and bone marrow specimens examined by light microscopy showed few cells with the numerous coarse, azurophilic granules typical of APL. Cytogenetic analyses, with several banding techniques, of cells from bone marrow and unstimulated peripheral blood revealed the 15;17 translocation, which has been observed only in APL. A reinterpretation of the reciprocal translocation, based on R banding, suggests that the breakpoints are distal to q24 in No. 15 and at or near the junction of q21 and q22 in No. 17. In addition, the patient had disseminated intravascular coagulation. The characteristic morphology of granules seen in APL was observed in this case only when transmission electron microscopy was used, since the granules were quite small. Since treatment for AML differs from that for APL, identification of the 15;17 translocation and ultrastructural evidence of granules represent valuable diagnostic aids for APL.

Download Full-text

Investigations of significance of blood smear results in diagnostics of infectious and parasitic diseases in dogs

Veterinarski glasnik ◽

10.2298/vetgl1006375p ◽

2010 ◽

Vol 64 (5-6) ◽

pp. 375-384

Author(s):

Aleksandar Potkonjak ◽

Branislav Lako ◽

Branislava Belic ◽

Nikolina Milosevic ◽

Ognjen Stevancevic ◽

...

Keyword(s):

Microscopic Examination ◽

Peripheral Blood ◽

Blood Smear ◽

Peripheral Blood Smear ◽

Parasitic Diseases ◽

Neutrophil Granulocyte ◽

Inexpensive Method ◽

Blood Smears ◽

Dog Blood ◽

Peripheral Blood Smears

The microscopic examination of stained smears of peripheral blood is of vital significance in the speedy diagnostics of infectious and parasitic diseases, in particular during the stage of infection when the cause is present in the blood, or blood cells. It is sometimes possible to make a definitive diagnosis of an infectious or parasitic disease following an examination of a stained smear of the peripheral blood. Since microscopic examinations of a peripheral blood smear are applied increasingly rarely in clinical practice, due to the development of other methods for the diagnostics of infectious and parasitic diseases in dogs, as well as the lack of knowledge of the morphology of the numerous causes that can be present in the blood, we carried out an investigation into the presence and spread of infections whose causes can be present in dog blood. The investigations covered 100 dogs from which peripheral blood smears were taken and then stained with a Giemsa solution according to the standard protocol and examined under a microscope with an immersion lens. The examination of peripheral blood smears stained according to Giemsa resulted in the identification of the presence of an Ehrlichia spp. morula in a neutrophil granulocyte in one dog. The presence of hemotropic mycoplasmas was established in erythrocytes of eleven dogs, while the presence of the protozoa Babesia canis in erythrocytes was identified in five dogs included in the investigations. A microscopic examination of dog peripheral blood smears stained according to Giemsa was shown as a speedy, practical, simple, and inexpensive method for making a definitive etiological diagnosis of these infections, and it should be included regularly in standard protocols for the diagnostics of infectious and parasitic diseases.

Download Full-text

A quick and reliable method for estimating platelet count on unstained peripheral smears in comparison to stained peripheral blood smears

International Journal of Clinical and Diagnostic Pathology ◽

10.33545/pathol.2020.v3.i2b.234 ◽

2020 ◽

Vol 3 (2) ◽

pp. 90-93

Author(s):

Dr. Anuja Dasgupta ◽

Dr. Nanditha HS ◽

Dr. Subhashini R ◽

Dr. Vidya R

Keyword(s):

Platelet Count ◽

Peripheral Blood ◽

Reliable Method ◽

Blood Smears ◽

Peripheral Blood Smears

Download Full-text

Brightfield and fluorescence in-channel staining of thin blood smears generated in a pumpless microfluidic

Analytical Methods ◽

10.1039/d1ay00195g ◽

2021 ◽

Author(s):

Kokou S. Dogbevi ◽

Paul Gordon ◽

Kimberly L. Branan ◽

Bryan Khai D. Ngo ◽

Kevin B. Kiefer ◽

...

Keyword(s):

Peripheral Blood ◽

Blood Smears ◽

Peripheral Blood Smears ◽

Thin Blood Smears

Effective staining of peripheral blood smears which enhances the contrast of intracellular components and biomarkers is essential for the accurate characterization, diagnosis, and monitoring of various diseases such as malaria.

Download Full-text