Interest of the XN-10® Analyzer to Screen for Myelodysplastic Syndromes on Complete Blood Count (CBC) Especially with Hemoglobin Levels and Neut-WX

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5518-5518
Author(s):  
Robin Boutault ◽  
Sebastien Tremblais ◽  
Mathilde De Oliveira Lopes ◽  
Pierre Peterlin ◽  
Yannick Le Bris ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Blood Count ◽  
Complete Blood Count ◽  
Conflicts Of Interest ◽  
Normal Karyotype ◽  
University Hospital ◽  
Multilineage Dysplasia ◽  
End Point ◽  
Group 2 ◽  
A Prospective Study

Abstract A prospective study was performed over one year at Nantes University Hospital in France, in order to investigate whether suspected myelodysplastic syndromes (MDS) could be detected on a complete blood count (CBC), the most rapid laboratory investigation. Indeed, the recently developed XN-10® (Sysmex, Kobe, Japan), provides novel CBC parameters witch could be useful to discriminate such patients from normal samples or from cytopenia of other etiology. Seventy-nine patients were enrolled in the study, for whom a diagnosis of MDS was concluded based on CBC, bone marrow smears examination and karyotype. All patients were free of treatment, including transfusions, at inclusion. They were 40 men and 39 women with a median age of 77,9 years (range 36,4-92,4). CBC were performed on a Sysmex analyzer XN-10®, including investigation of reticulocytes and fluorimetric analysis of platelets. For comparison with normal values, results from 776 healthy samples, for which CBC were performed on the same analyzer and generated no flag, were used. All had parameters within the normal range according to age. The classical parameters of hemoglobin level, Mean Corpuscular Volume (MCV), reticulocytes, platelets and neutrophil counts were recorded. In addition, the extra-parameters, immature reticulocytes fraction (IRF%), platelets by fluorescence (PLT-F) and immature platelets fraction (IPF%), were taken into account. The neutrophils median position on the three axes as well as their dispersion (Neut-WX) were also measured by the analyser. The primary end-point was to discriminate between MDS and healthy patients and the secondary end-point was to distinguish MDS with excess blasts, MDS with multilineage dysplasia and MDS with single lineage dysplasia within the MDS group and by comparison with controls. According to the WHO 2016 classification, 27 patients in the cohort had MDS with excess blasts, 26 MDS with multilineage dysplasia (among whom 7 had ring sideroblasts [RS], group 2), 16 MDS-RS and single lineage dysplasia, 7 MDS with single lineage dysplasia and 3 MDS with isolated del(5q). Forty-four patients had a normal karyotype and 28 displayed anomalies classically reported in MDS, including 5 complex karyotypes. Among the latter, 4 were associated with MDS with excess blasts. Both classical and extra parameters indeed showed significant differences between the subgroups tested. Among the whole group of MDS patients, a number of parameters of all lineages were statistically different from the healthy cohort. The median level of hemoglobin was 9,8 g/dL (range 4,7-14,9), (p<0,0001), the median MCV 104,3 fL (range 75,4-123,9; p<0,0001), reticulocyte counts 44,3x109/L (range 8-165,9; p=0,041) and IRF% 16,7% (range 2,4-50,9; p<0,0001). An hemoglobin value below 11,5 g/dL was strongly suggestive of MDS with a sensitivity of 81% and specificity of 100%. The median platelet count was 164x109/L (range 8-505; p<0,0001) and median IPF% 8,8% (1,2-42; p<0,0001). Among leukocyte parameters, the MDS median neutrophil count was significantly lower at 2,15x109/L (range 0,17-13,67; p<0,001) and the Neut-WX value increased above 350. The latter, by itself, allowed to make a diagnosis of MDS with a sensitivity of 73,1% and a specificity of 96,9%. When considering the three MDS subgroups of MDS with excess blasts, multilineage or single lineage dysplasia, although each of them was significantly different from controls for hemoglobin levels, MCV, IRF% and neutrophil counts (p<0,0001), they could not be discriminated by these parameters. In the subgroup of MDS with single lineage dysplasia, platelet counts were similar to those of controls, yet significantly higher than for MDS with excess blast or with multilineage dysplasia (p=0,004 and p=0,029 respectively). Taken together, this study demonstrates that a simple CBC allows to screen for MDS using thresholds of 11,5 g/dL for hemoglobin and of 350 for Neut-WX. Blood smear examination should be performed in this situation even if the XN-10® analyzer does not raise an alarm, especially in unknown older patients. Disclosures No relevant conflicts of interest to declare.

New strategy of early detection of myelodysplastic syndromes on the complete blood count with Unicel DxH 800 Coulter® analyzer

2019 ◽  
Vol 493 ◽  
pp. S28-S29
Author(s):  
N. Ravalet ◽  
F. Picou ◽  
M. Gombert ◽  
A. Foucault ◽  
E. Renoult ◽  
...  
Keyword(s):  
Early Detection ◽  
Myelodysplastic Syndromes ◽  
Blood Count ◽  
Complete Blood Count ◽  
New Strategy

Concomitant Rash and Blood Dyscrasias in Geriatric Psychiatry Patients Treated with Carbamazepine

1998 ◽  
Vol 32 (9) ◽  
pp. 884-887 ◽  
Author(s):  
Marshall Cates ◽  
Richard Powers
Keyword(s):  
Blood Count ◽  
Geriatric Patients ◽  
Complete Blood Count ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Geriatric Psychiatry ◽  
Drug Induced ◽  
Carbamazepine Therapy ◽  
A Prospective Study ◽  
The Relationship

BACKGROUND: Rashes and blood dyscrasias are disconcerting adverse effects associated with carbamazepine therapy. Rashes are quite common, as are mild blood dyscrasias, such as mild leukopenias. Fortunately, severe rashes and blood dyscrasias are rare. There are few reports on the relationship between carbamazepine-induced rashes and blood dyscrasias, including a prospective study in which rash appeared concomitantly with leukopenia and/or thrombocytopenia in 10 patients, two case reports in which simultaneous rash and agranulocytosis occurred, and two case reports in which rashes served as harbingers of fatal aplastic anemia. CASE REPORTS: We report two cases of concomitant rashes and blood dyscrasias in geriatric psychiatry patients receiving carbamazepine therapy for bipolar disorder. One patient was found to have a severe leukopenia within several days after rash onset. The other patient was discovered to have a severe leukopenia and thrombocytopenia within about a month after rash onset. DISCUSSION: Current hematologic monitoring guidelines for carbamazepine rely heavily on the recognition of signs and symptoms of blood dyscrasias by clinicians and patients. We believe that our cases support the suggestion that patients who develop rashes receive more vigilant monitoring of the complete blood count, should carbamazepine therapy be continued. Given the currently available case reports and the fact that the incidence of drug-induced blood dyscrasias increases with advanced age, this recommendation may be particularly relevant for geriatric patients. CONCLUSIONS: Further study is required to establish whether carbamazepine-induced concomitant rashes and blood dyscrasias are valid associations insofar as monitoring is concerned.

Myelodysplastic Syndromes: A Multidisciplinary Integrated Diagnostic Work-up for Patients' Risk Stratification

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5579-5579
Author(s):  
Elena Ciabatti ◽  
Maria Immacolata Ferreri ◽  
Angelo Valetto ◽  
Alice Guazzelli ◽  
Veronica Bertini ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Mutational Analysis ◽  
Conflicts Of Interest ◽  
Normal Karyotype ◽  
Diagnostic Workup ◽  
Fish Analysis ◽  
Rt Pcr ◽  
Risk Scoring ◽  
Conventional Cytogenetics ◽  
Work Up

Abstract Conventional cytogenetics continues to have a fundamental role in the classification and risk scoring of myelodysplastic syndromes (MDS). Nevertheless, non-informative karyotypes represent up to 20% of cases. Some different molecular methods, not included in the routinary diagnostic workup, such as aCGH or mutational analysis, could be able to detect new abnormalities and improve the subtyping of MDS. The aim of this study was to propose a new diagnostic workup to determine the eventual adjunctive value offered by FISH, aCGH, and somatic mutation assays in respect of the the conventional cytogenetics only. In this study, we analyzed 50 patients: 29% female and 71% male, median age 71 (range 30-88 years), 66% at low/int1 IPSS risk, 54% at very-low/low R-IPSS risk, 33% with RCMD, 15% with RA, 14% with RARS, 14% with RAEB, 8% 5q-, and 16% with MMCL. We assessed these new MDS cases by different techniques: i) conventional cytogenetics; ii) FISH for chromosome 5, 7, PDGFRa, and PDGFRb; iii) aCGH, and iiii) specific RT-PCR for ASXL1, EZH2, TP53, and TET2 mutations. Conventional cytogenetics showed 42% of patients with at least one chromosomal aberration, including +8, del(11), del(7), del(5), -Y, +6, del(13), +14, del(20), and complex karyotypes (6% of cases). After FISH analysis, we were able to correctly classify as affected by the 5q- syndrome 2 cases who then received lenalidomide. The aGCH allowed to detect quantitative chromosomal aberrations in 44% of cases (del(13), -7, del(12), del(16), del(17), del(11), del(8), dupl(14), 5q-), including 10 cases (20%) showing a normal karyotype. After the RT-PCR, 32% of patients resulted mutated, with highest frequency for TP53 (22%). Four of these TP53-mutated patients showed normal karyotype, and resulted unmutated also by FISH and aCGH; in a case TP53 mutated we added treatment with steroid. Other 3 patients TP53-mutated did not respond to azacitidine Four low-risk patients (8%) showed ASXL1 gene mutation, three of them not earlier detected by cytogenetics or aCGH. One of these patients died after progression into acute leukemia. The identification of TP53 or ASXL1 mutations after RT-PCR and of dupl(14) by the aCGH prompted us to strictly follow patients at high risk of transformation. Only one case showed TET2 mutation; although TET2 mutations have been related to a better survival in patients receiving 5-azacitidine, this patient resulted not-responsive after 9 cycles. In conclusion, these results sustain the necessity of an integrated work-up for the diagnosis and the correct risk scoring of MDS patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Prediction of the Course of Transient Tachypnea of the Newborn by Blood Laboratory Parameters at the Time of Admission

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sadrettin Ekmen ◽  
Erkan Doğan
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Blood Count ◽  
Complete Blood Count ◽  
Early Period ◽  
Blood Gases ◽  
Prolonged Stay ◽  
Partial Carbon Dioxide Pressure ◽  
Carbon Dioxide Pressure ◽  
Group 2

Background: Transient tachypnea of the newborn (TTN) is a common but mild respiratory problem seen in late preterm and term newborns. However, it may sometimes cause severe morbidity. Objectives: Therefore, biomarkers that can predict TTN severity may aid the clinician in determining the need for intensive care. Our aim was to identify whether blood gases and complete blood count parameters could be utilized to predict the severity of TTN.s Methods: We retrospectively examined the medical records of newborns (> 37 weeks gestation, > 2000 grams) diagnosed with TTN who were hospitalized in the Neonatal Intensive Care Unit (NICU) of Karabuk University Faculty of Medicine, Training and Research Hospital, Karabük/Turkey between June 2019 and June 2020. Patients were grouped according to the length of stay in the NICU. Group 1 included patients that did not require NICU monitoring after 48 hours, and group 2 included patients who continued to require NICU monitoring after 48 hours. Blood gases and complete blood count parameters were compared between the two groups. Results: During the study period, 91 newborns were hospitalized in the NICU due to respiratory distress. Thirty-nine patients who did not meet the inclusion criteria were excluded. Gestational age and birth weight were significantly lower in group 2 (P < 0.05). There were no significant differences between the groups in terms of leukocyte count, hemoglobin level, mean platelet volume (MPV), and platelet count. Partial carbon dioxide pressure (PCO2) was significantly elevated, and base excess (BE) was significantly greater in group 2. Conclusions: We determined a relationship between a prolonged stay in NICU and the levels of PCO2 and BE among patients hospitalized with a diagnosis of TTN. Therefore, PCO2 and BE values may be valuable to determine the prognosis of TTN in the early period. Despite being one of the most common causes of intensive care admission in the newborn population, there is limited data on the diagnosis, treatment, and prognosis of TTN; thus, we believe that our results will shed light on this problem.

scholarly journals Importance of haemogram parameters for prediction of the time of birth in women diagnosed with threatened preterm labour

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052091843
Author(s):  
Harun Egemen Tolunay ◽  
Erkan Elci
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Blood Count ◽  
Complete Blood Count ◽  
Preterm Labour ◽  
Blood Cell Count ◽  
Group 2 ◽  
Lymphocyte Cell ◽  
Neutrophil Cell ◽  
Group 1

Objective This study aimed to estimate the importance of complete blood count parameters for predicting the timing of birth in threatened preterm labour cases. Methods We performed a retrospective study of 92 patients who were diagnosed with threatened preterm labour (24–34 gestational weeks). The patients were divided into two groups according to the time of birth (group 1: delivered within the first week after diagnosis; group 2: delivered later than 1 week). We compared characteristics and complete blood count parameters between these two groups. Results There were no significant differences in maternal age, body mass index, gravida, parity, haemoglobin levels, and gestational weeks between the two groups. The mean cervical length was 24.24 ± 3.60 mm in group 1 and 30.70 ± 5.32 mm in group 2. There were significant differences in the neutrophil to lymphocyte ratio, white blood cell count, red cell distribution width (RDW), absolute lymphocyte cell count, and absolute neutrophil cell count between the two groups. Conclusion Maternal serum RDW, the neutrophil to lymphocyte ratio, white blood cell count, absolute lymphocyte cell count, and the absolute neutrophil cell count profile could guide clinicians in predicting the time of birth in threatened preterm labour cases.

Azacitidine and Lenalidomide Combination In Higher-Risk Myelodysplastic Syndromes-Preliminary Results Of The Vilen-01 Protocol

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1576-1576 ◽  
Author(s):  
Moshe Mittelman ◽  
Kalman Filanovsky ◽  
Hanna Rosenbaum ◽  
Pia Raanani ◽  
Andrei Braester ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Conflicts Of Interest ◽  
Single Agent ◽  
Normal Karyotype ◽  
Response Duration ◽  
Cytogenetic Response ◽  
High Response Rate ◽  
Induction Phase ◽  
Platelet Response ◽  
Erythroid Response

Abstract Background Hypomethylating agents are the standard therapy for higher-risk (HR, Int-2 and high-risk) myelodysplastic syndromes (MDS). Lenalidomide is effective in lower-risk (LR) MDS, with or without 5q-, in HR-MDS and in acute leukemia. Many patients remain resistant to a single agent. A potential synergistic effect of both agents has been shown [Sekeres M et al, Am J Hemat 2010; Blood 2012]. Thus, the MDS Israel group has designed a phase II clinical trial (NIH trial #: TASMC-10-MM-0437-09-CTIL). Protocol The ViLen-01 protocol consists of 3 phases. The induction phase includes 6 monthly cycles of SC azacitidine (Aza), 75 mg/m daily, days 1-5, and PO lenalidomide (Len) 10 mg daily, days 6-21, followed by a 7-day (days 22-28) respite. The consolidation consists of 6 monthly cycles of Aza only for 5 days each, followed by 12 months of maintenance with Len only. Response is evaluated by the IWG criteria [Cheson B et al, Blood 2006]. Results As of July 2013, 7 medical centers have enrolled 18 patients. Patients had been diagnosed with either HR-MDS, or LR-MDS with transfusion-dependence, erythropoietin resistance and poor cytogenetics. Adverse events (AE) were as expected in these elderly HR-MDS patients. The common AEs were grade IV transient cytopenias, requiring dose modification in 15 patients. Only 2 patients stopped the protocol due to AE. Thirteen patients completed the induction, 8 continued to consolidation, and 5 patients continued to maintenance. Eight of the 18 enrolled patients (44%, 8 of the 13, 61.5%) who had completed the induction, achieved CR. Three of the 8 patients in CR also attained cytogenetic response. The other 5 had normal karyotype on study initiation. Five other patients obtained erythroid response and became transfusion-free, and another patient achieved platelet response, for a total of 14 (78%) responders. It is still too early to evaluate response duration and survival. One patient is in early induction, and 4 are still being treated. The others have either died or have discontinued for various reasons (patient refusal, progressive disease, transplant). Conclusions These preliminary data in a small group of patients with HR-MDS and expected poor prognosis, demonstrate a high response rate and a reasonable safety profile. The study is ongoing. If these results are confirmed in randomized trials, it may set new standards for the treatment of this disease. Disclosures: No relevant conflicts of interest to declare.

Automated screening for myelodysplastic syndromes through analysis of complete blood count and cell population data parameters

2014 ◽  
Vol 89 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Philipp W. Raess ◽  
Gert-Jan M. van de Geijn ◽  
Tjin L. Njo ◽  
Boudewijn Klop ◽  
Dmitry Sukhachev ◽  
...  
Keyword(s):  
Cell Population ◽  
Myelodysplastic Syndromes ◽  
Blood Count ◽  
Complete Blood Count ◽  
Population Data ◽  
Automated Screening

scholarly journals Retrospective Study of High Hemoglobin Levels in 56 Young Adults

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1262-1262
Author(s):  
Alexandra Desnoyers ◽  
Michel Pavic ◽  
Jean-Francois Castilloux ◽  
Patrice Beauregard ◽  
Line Delisle ◽  
...  
Keyword(s):  
Young Adults ◽  
Complete Blood Count ◽  
Conflicts Of Interest ◽  
University Hospital ◽  
Jak2 Mutation ◽  
Female Ratio ◽  
Myeloproliferative Syndrome ◽  
Age Range ◽  
Made In

Abstract Introduction. Erythrocytosis is a common reason for a hematology consultation. Most of the patients are over 50 years of age. The diagnostic approach is already well established, but determining the etiology of erythrocytosis in the young adult may be a real diagnostic challenge. Hereditary causes are often first suspected, but the real etiologic panorama of erythrocytosis in this population is still poorly understood. Methods. This Canadian single-center retrospective observational study was conducted in a Québec university hospital over a period of 20 years (1995 - 2015). Data were collected by a single investigator in a standardized database. From a computer-generated query over a chosen period of time, all patients between 16 and 35 years of age with high levels of hemoglobin or hematocrit were selected (hemoglobin > 185 g/L and/or hematocrit > 0.52 in men; hemoglobin > 165 g/L and/or hematocrit > 0.48 in women). Files were analyzed after approval from the scientific and ethical committees. Results. 426 patients fulfilled the above criteria (on a total of 113 453 complete blood counts conducted in the same age range during the analysis period), but only 56 benefitted from further investigations. Only those cases were included in the study. The male-to-female ratio was 5 : 3. Among them, 59% were smokers, 11% had a high alcohol intake and 27% were using drugs on a regular basis. Obesity was present in 43% of patients (morbid obesity in nearly one third of cases). More than half of the patients had one visit or less with a specialist for investigation of their erythrocytosis. Among those who had a medical follow-up, the median length is 42 months. Erythropoietin was measured in 23% of cases and the JAK2 mutation was screened in 18% of cases. The diagnosis of an acquired polycythemia was made in 41% of cases: hypoxemia (n= 13), renal disorders (n = 6) and drug-induced (n= 4). No case of myeloproliferative syndrome was identified. Two cases were associated with congenital polycythemia (high oxygen affinity hemoglobinopathy). Diagnosis of relative polycythemia was made in slightly over 10% of cases (n= 7). In 24 patients, no conclusive cause could be identified. One third of those patients (n= 8) were hospitalised for mental health decompensation or self-induced intoxication when high hemoglobin levels were detected. When JAK2 mutation testing was not available, the complete blood count was further analyzed and it did not provide any evidence for myeloproliferative syndrome. One in five patients received treatment for their polycythemia, whatever the cause: aspirin (n= 7) and phlebotomy (n= 5). There has been no reported patient death associated with polycythemia or its treatment. Only two major complications occurred: thrombosis (n =1) and bleeding (n= 1). Conclusion. This is the first study to specifically analyze erythrocytosis in young adults. Despite the retrospective design, it demonstrates patient management often inconsistent with the actual recommendations and a lack of follow-up after initial investigations. Congenital polycythemia deserves to be systematically evoked in this age range, but represents only a small part of cases. Acquired polycythemia dominates the etiologies whereas myeloproliferative syndromes were not depicted in this study. Harmonisation of patient care for young adults with erythrocytosis is therefore highly desirable. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Comparison of Complete Blood Count Reference Intervals in Healthy Elderly Versus Younger Korean Adults: A Large Population Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4708-4708
Author(s):  
Young Kyung Lee ◽  
Eun Jin Lee ◽  
Miyoung Kim ◽  
Eunyup Lee ◽  
Kibum Jeon ◽  
...  
Keyword(s):  
Blood Count ◽  
Complete Blood Count ◽  
Conflicts Of Interest ◽  
Large Population ◽  
Age Groups ◽  
Reference Interval ◽  
Reference Intervals ◽  
Healthy Elderly ◽  
Elderly Koreans ◽  
Lower Limits

Abstract Background: The use of laboratory reference intervals based on younger populations is of questionable validity in older populations. We established reference intervals for 16 complete blood count (CBC) parameters in healthy elderly Koreans aged ≥60 years and compared them to those of individuals aged 20-59 years. Methods: Among 64,532 individuals (39,609 men and 24,923 women) aged ≥20 years who underwent medical check-ups, 8,151 healthy subjects (12.6%, 5,270 men and 2,881 women, including 675 and 511, respectively, who were ≥60 years of age) were enrolled based on stringent criteria including laboratory, imaging, and endoscopy results; previous medical history; and medication history. CBC parameters were measured using an Advia2120i instrument. The difference between 2 age groups in subjects of each sex was compared using the Mann-Whitney U-test. P-values <0.05 were considered statistically significant. The reference intervals for measured CBC parameters were established according to a nonparametric method based on the CLSI EP28A-3C in each subgroup. The 90% confidence intervals for the upper and lower limits of each reference interval were calculated; the Reed method was used to remove extreme outliers. The Harris and Boyd method was used to determine the necessity of separating the reference intervals for different age groups within each sex group. To identify reference intervals in different age groups in individuals aged 60 years and over, such individuals of each sex were subdivided into 5 age subgroups with 5-year age interval: since the sizes of 4 of these subgroups were not sufficiently large, we used the Robust method. Results: A statistical difference in the medians of the following parameters were observed between the <60- and ≥60-year age groups: RBC, Hb, hematocrit (Hct), basophils, and platelets in men aged <60 years were higher than those in men aged ≥60 years; furthermore, MCV, MCH, and RDW in men aged ≥60 years were higher than those in men aged <60 years. Neutrophils in women aged <60 years were higher than in those aged ≥60 years. Hb, Hct, MCV, MCH, MCHC, lymphocytes, and basophils in women aged ≥60 years were higher than in those aged <60 years. Separate reference intervals were required only for RDW and MCH in women ≥60 from those < 60 years of age. Men aged ≥60 years versus those <60 years did not require separate reference intervals for any of the 16 measured parameters. In subjects aged ≥60 years, RBC, Hb, Hct, MCV, MCH, MCHC, RDW, WBC, neutrophils, monocytes, eosinophils, MPV, and PDW were higher in men than in women, while the opposite was true for lymphocytes and platelets. Partitioning of reference intervals by sex was required for RBC, Hb, Hct, MCH, monocytes, and eosinophils. In men, median values and the lower limits of the reference intervals for RBC, Hb, and Hct tended to decrease with advancing age. The upper and lower limits of reference intervals for WBC, neutrophils, lymphocytes, and MPV also showed increasing and decreasing tendencies, respectively, widening the reference intervals as the subjects aged (except in the 70-74-year-old group for men). Among women, the lower limits of the reference intervals for RBC, Hb, and Hct showed a tendency to decrease with increasing age for those >70 years of age; however, the median values did not show such a tendency. The reference interval for PDW narrowed as women aged. Separate reference intervals were required among men for MCH and eosinophils in the 70-74-year group, and for basophils in the 65-69-year group. Among women, separate reference intervals were required for MCV in the 65-69-year group; for MCH in the 60-64, 65-69, and ≥75-years groups; and for RDW in all the 4 elderly age subgroups. Conclusion: Healthy elderly Koreans can use the same reference intervals as younger populations. Thus, abnormal CBC results may not necessarily be attributable to physiologic changes but possible underlying diseases that should be investigated. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Case of Myelodysplastic Syndrome with Clinical Manifestations of Recurrent Cellulitis

2020 ◽  
Vol 16 (3) ◽  
pp. 202-206
Author(s):  
Jung Han Lim ◽  
Sue Min Kim ◽  
Seungyun Jee ◽  
Seong Oh Park
Keyword(s):  
Conservative Treatment ◽  
Myelodysplastic Syndrome ◽  
Myelodysplastic Syndromes ◽  
Blood Count ◽  
Complete Blood Count ◽  
Clinical Manifestations ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Intravenous Antibiotics ◽  
Laboratory Results

An 84-year-old male patient with recurrent cellulitis in the left submandibular area visited the outpatient clinic. He underwent debridement of the wound with administration of intravenous antibiotics. The defect was reconstructed using a split-thickness skin graft. After 2 months, the cellulitis recurred adjacent to the prior lesion in the submandibular area. The wound improved with intravenous antibiotics and conservative treatment. During the second hospitalization, the patient was evaluated for abnormal complete blood count, and was finally diagnosed with myelodysplastic syndromes. Recurrent cellulitis in this patient was not accompanied with any other symptoms; instead of being a simple uncontrolled infection it had a systemic origin. Physicians should consider the possibility of systemic causes for recurrent cellulitis, such as myelodysplastic syndromes, especially if laboratory results suggest pancytopenia.

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