Estimation and comparison of thrombocyte count by peripheral blood smear method and automated method in women with pregnancy

Background: Thrombocyte is important and very essential component of blood and have significant role in maintenance of hemostasis. Thrombocyte count is an important investigation done in various acquired and congenital coagulable states which include conditions like pregnancy. Thrombocyte count is routinely done by automated hematology analyzer method. The automated hematology analyzer counters are not usually available at all centres especially in peripheral and rural side though thrombocytes can also be assessed from the peripheral blood smears, which can be easily and precisely done at any set up. Aim and objective of this study was to compare the thrombocyte estimation by peripheral blood smear method and automated hematology analyzer in pregnant women.Methods: Thrombocyte estimation was done from samples taken from 120 normal pregnant women between December 2018 to March 2019, where samples were Ethylene Diamine Tetra Acetic acid (EDTA) anticoagulated. Thrombocyte was counted manually using PBS (Leishman stain) and hematology analyzer (Sysmex XN1000 series). Thrombocyte counts were expressed in Mean and standard Deviation. Statistical analysis was done by student’s t test using MS excel and SPSS version 17.Results: Thrombocyte count by PBS have mean value of 2.04 lacs/mm3 with standard deviation of 0.56 lacs/mm3 and by automated method have mean value of 1.89 lacs/mm3 and standard deviation of 0.71 lacs/mm3 with p value 0.010. Thus, there was no statistically significant difference found between two methods.Conclusions: Estimation of thrombocyte count on the basis of manual thrombocyte count is a reliable technique and can be used to validate automated thrombocyte counts. It can also be used in under resourced laboratories, where there are no automated counters of good precision available. In fact, all the tests showing abnormal thrombocyte counts must be reported only after cross examining on PBS.

Download Full-text

Clinical Characteristics of Patients with a RBC Fragment Flag on the Advia® 2120 Automated Hematology Analyzer.

Blood ◽

10.1182/blood.v110.11.5153.5153 ◽

2007 ◽

Vol 110 (11) ◽

pp. 5153-5153

Author(s):

Jonathan Ben-Ezra

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Peripheral Blood ◽

Blood Smear ◽

Lymphoblastic Leukemia ◽

Peripheral Blood Smear ◽

Deficiency Anemia ◽

Clinical Criteria ◽

Hematology Analyzer ◽

Automated Hematology Analyzer

The clinical diagnosis of thrombotic thrombocytopenia purpura (TTP) is a difficult one to make. It is based on clinical criteria, one of which is a microangiopathic hemolytic anemia, characterized morphologically by the presence of schistocytes on the peripheral blood smear. The ADVIA 2120 automated hematology analyzer is able to quantify the presence of red blood cell (RBC) fragments. We studied the ability of the ADVIA 2120 to be able to detect RBC fragments in the blood of TTP patients, and the characteristics of all patients in whom RBC fragments were obtained. During the study period, 6 TTP patients were studied. The initial numbers of RBC fragments ranged from 0.02–0.05 × 106 cells/μl. During the course of plasmapheresis, these numbers decreased to 0.00–0.02 × 106 cells/μl, corresponding to a rise in the platelet count. Figure Figure In the course of a month, 52 blood samples on 39 patients were flagged by the hematology analyzer to have RBC fragments (0.01–0.12 × 106 cells/μl). 52 Samples with RBC Fragment Flag Hemoglobin Platelets RDW Range 4– 14.3 g/dl 5–906 × 103/ul 13.9– 28.6% Number Abnormal 46 (<13.0 g/dl) 23 (<160 × 103/ul) 51 (>14.1%) Within this population, there were two patients with TTP, and one with DIC. Four of the samples did not have detectable schistocytes upon visual inspection of the peripheral blood smear. There were 19 samples from 14 patients who had RBC fragment counts ≥ 0.04 × 106 cells/μl. 19 Specimens with RBC Fragments ≥ 0.04 × 106/ul Hemoglobin Platelets RDW Range 8– 14.1 g/dl 59– 906 × 103/ul 16.4– 25.3% Number Abnormal 15 (<13 g/dl) 4 (<160 × 103/ul) 19 (>14.1%) The diagnoses in these 14 patients were iron deficiency anemia (4 patients), thalassemia trait (2), acute lymphoblastic leukemia (2), and one each with TTP, sickle cell anemia, heart failure, kidney stone, cerebrovascular accident (CVA), and end stage renal disease. We conclude that the RBC fragment flag on the ADVIA 2120 is nonspecific. Although it does detect schistocytes in TTP, these are often present in low numbers. Quantitatively, the most numerous RBC fragments are found in diseases with marked anisopoikilocytosis, such as iron deficiency anemia.

Download Full-text

Comparison of peripheral blood smear examination with automated haematology analyzer for diagnosing different types of anemia.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.10.6179 ◽

2021 ◽

Vol 28 (10) ◽

pp. 1433-1437

Author(s):

Rabiah Asghar ◽

Javera Tariq ◽

Nabeela Naeem ◽

Anila Zafar ◽

Khadija Qureshi ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Peripheral Blood ◽

Blood Smear ◽

Hypochromic Anemia ◽

Peripheral Blood Smear ◽

Smear Examination ◽

Blood Smear Examination ◽

Hematology Analyzer ◽

Different Types ◽

Automated Hematology Analyzer

Objective: This study aims to determine diagnostic accuracy of peripheral blood smear and automated haematology analyzer and to determine frequency of different types of anemia diagnosed by peripheral blood smear and automated hematology analyzer. Study Design: Cross Sectional study. Setting: Department of Pathology, Rawal Institute of Health Sciences, Islamabad. Period: November 2015 to April 2016. Material & Methods: Sample size of 149 suspected anemia patients was calculated using WHO calculator with 95% confidence interval. Research approval was taken from hospital ethical board. Patients were approached through non probability consecutive sampling method. Both peripheral blood smear examination and automated haematology analysis of each sample was performed. Diagnostic accuracy and frequency of anemia types was measured. Data analysis was done with the help of SPSS version 25. Chi-square and fissure exact test and ROC curve analysis was applied and significant (p<0.05) results were reported. Results: Total 149 patients were included in study. There were 42(28.2%) male and 107(71.8%) female. Mean age of patients was 35.1±2.1SD. Peripheral blood smear and automated haematology analyzer showed sensitivity (68% vs 92%), specificity (59% vs 88%), PPV (72% vs 92%), NPV (55% vs 88%) and diagnostic accuracy (64% vs 91) respectively. Most common type of anemia diagnosed with peripheral blood smear was microcytic hypochromic anemia with raised RDW 36.7% followed by normocytic normochromic anemia with raised RDW 13.3% and macrocytic anemia (p=0.001) while in automated haematology analyzer microc ytic hypochromic anemia with raised RDW54.4% followed by normochromic normocytic anemoia with normal RDW 11.1% (p=0.000). Conclusion: Automated haematyology analyzer had high diagnostic accuracy for diagnosis of anemia. Microcytic hypochromic anemia and normocytic normochromic are most common anemias diagnosed by peripheral blood smear and automated hematology analyzer and peripheral blood smear cannot be completely replaced by automated haemolytic analyzer. However, if both methods are used simultaneously, more accurate results can be obtained.

Download Full-text

Utility of peripheral blood smear in platelet count estimation

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20190348 ◽

2019 ◽

Vol 7 (2) ◽

pp. 434 ◽

Cited By ~ 1

Author(s):

Vyankatesh T. Anchinmane ◽

Shilpa V. Sankhe

Keyword(s):

Platelet Count ◽

Peripheral Blood ◽

Blood Smear ◽

Peripheral Blood Smear ◽

Severe Thrombocytopenia ◽

Correlation Test ◽

Hematology Analyzer ◽

Pearson's Correlation ◽

Automated Hematology Analyzer ◽

Count Estimation

Background: There are several methods of platelet count used in hematology laboratory. These methods are manual counting, automated hematology analyzer counting, platelet count estimation by peripheral blood smear (PBS) method etc. Many diseases such as dengue, malaria, pregnancy induced hypertension etc. may leads to severe thrombocytopenia. Timely and precise diagnosis of platelet count plays very crucial role in critical care management of thrombocytopenia cases. The present study was undertaken to estimate platelet counts by PBS method and correlate them with results from automated hematology analyzer method.Methods: Study included one hundred randomly collected blood samples in EDTA anticoagulant vacutainer tubes. Each blood sample was processed for platelet count estimation with automated hematology analyzer and Leishman’s stained PBS examination. The statistical analysis was done by using Pearson's correlation test to access the agreement between both the methods.Results: The Pearson's correlation test showed significant positive correlation for platelet count estimation between both the methods. (r =0.9789).Conclusions: Platelet count estimation by PBS method is reliable and statistically significant when compared to hematology analyzer method. PBS platelet estimation method can be taken as early and rapid procedure for platelet assessment in critical severe thrombocytopenia cases. This method is simple, cheaper and can be done in rural hospital setup where automation is not available.

Download Full-text