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

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.

scholarly journals Erythrocyte Morphology in Women of Reproductive Age (WORA) with Anemia

Biomedika ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 83-91
Author(s):  
Alex Jekson Tukira ◽  
Lucia Sincu Gunawan ◽  
Edy Prasetya
Keyword(s):  
Peripheral Blood ◽  
Blood Smear ◽  
Peripheral Blood Smear ◽  
Reproductive Age ◽  
Target Cells ◽  
Women Of Reproductive Age ◽  
Erythrocyte Morphology ◽  
Smear Examination ◽  
Blood Smear Examination ◽  
Laboratory Technology

Anemia is a decrease in the number of erythrocytes in the blood circulation or the level of hemoglobin that is less than normal. The three major body mechanisms that cause anemia are excessive destruction of erythrocytes, blood loss, and decreased erythrocyte production. Based on the Basic Health Research (Riskesdas) in 2013, the prevalence of anemic women of reproductive age (WORA) aged 15-44 years in Indonesia was 35.3%. Anemia is classified based on the morphology of erythrocytes, including hypochromic microcytic, normocytic normochromic, and macrocytic. Erythrocyte morphology can be observed using peripheral blood smear examination. The objective of this study was to determine the morphology of erythrocytes in anemic women of reproductive age. This study belongs to descriptive research. The population of the study was 136 women of reproductive age, covering the students of D-IV in Medical Laboratory Technology at Setia Budi University. Forty-one respondents suffering from anemia were taken using a purposive sampling technique. The types of anemia were determined with examination using an Easy Touch hemoglobinometer with the Hb level of less than 12g/dL. Preparation of peripheral blood smear examination using EDTA venous blood and stained with Giemsa. Microscopic examination was performed with 1000x objective magnification. The peripheral blood smear reading showed the erythrocyte morphology that includes normocytic normochromic (38 samples or 93%), microcytic hypochromic (three samples or 7%), and poikilocytosis consisting of teardrop cells, target cells, ellipstocytes, and stomatocytes (five samples or 18%). Further study is required to investigate the correlation of erythrocyte index and peripheral blood smear in anemia.

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

Blood ◽  
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.

scholarly journals Automated Early Detection of Myelodysplastic Syndrome with Beckman-Coulter DxH 800 Hematologyanalyzer By Using Ten Research Parameters

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5509-5509
Author(s):  
Noemie Ravalet ◽  
Frederic Picou ◽  
Martin Gombert ◽  
Amelie Foucault ◽  
Emmanuel Renoult ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Logistic Regression ◽  
Myelodysplastic Syndrome ◽  
Healthy Volunteers ◽  
Peripheral Blood ◽  
Blood Smear ◽  
P Value ◽  
Smear Examination ◽  
Blood Smear Examination ◽  
Hematology Analyzer

Abstract Introduction Moderate anemia affects a substantial fraction of the elderly population and blood smear analysis can help to guide towards a diagnosis of myelodysplastic syndrome (MDS). Nevertheless, in medical laboratories, review of blood smear is realized only if there is quantitative or qualitative flag on the complete blood count (CBC). Consequently, the suspicion of MDS could be delayed because of the absence of systematic blood smear triggering, this smear being crucial to induce the diagnosis process by cytological analysis of bone marrow aspiration. The DxH 800 Hematology Analyzer measures and calculates 126 cytological parameters based on photometry, impedance or light scatter. These parameters regroup 23 standard CBC parameters and 103 unexploited "research parameters". The goal of our study was to create an original mathematical model using "research parameters" to determine a Suspicion Score of MDS which triggers blood smear examination and consequently the process of identification of subclinical patients suffering from MDS. Methods This study compared the 126 parameters measured by the Beckman-Coulter DxH 800 Hematology Analyzer from peripheral blood samples of MDS patients and healthy volunteers. MDS cohort was composed of 101 patients of the university hospital of Tours (9 MDS-SLD, 28 MDS-MLD, 8 MDS-RS-SLD, 8 MDS-RS-MLD, 20 MDS-EB-1, 19 MDS-EB-2, 9 5q-). The cohort of healthy volunteers included 88 aged-matched subjects from HEALTHOX and PLASMYC protocols (ClinicalTrials.gov # NCT02789839 and # NCT02809222, respectively). The "research parameters" contained Research Use Only (RUO) parameters and Cell Population Data (CPD). CPD were composed of 98 parameters measured by Volume Conductivity Scatter (VCS) module. The parameters derived from reticulocytes, which require a specific prescription, were excluded. Statistical analyses were performed using Rstudio version 1.0.153. The normal distribution of values was studied by Shapiro-Wilk tests (p-value<0.05) and the homoscedasticity by Levene tests (p-value>0.05). Means comparisons were performed by Wilcoxon and Student tests. Principal component analysis (PCA) was performed using FactoMineR. The logarithmic logistic regression was done thanks to the glm() function of the stats package. The general linear model was obtained by using logistic regression with weighted parameters and was validated by split-sample strategy (10,000 repeats). Samples were divided into two groups ("learning" and "test" groups) randomly mixing MDS patients and healthy volunteers. The "learning" group (n=130) allowed to build the model and the "test" group (n=59) was used to validate it. Results After mono-parametric and multi-parametric comparisons, 10 parameters were selected to establish the model of interest according to the best contributions at the first axe of PCA, the best correlations at two first axes of PCA and the most significant p-values (parameters described in the Table: MN.LALS.NNRBC, MN.LMALS.NNRBC, MN.UMALS.NNRBC, SD.MALS.NE, SD.UMALS.NE, SD.V.NE, MN.MALS.NE, SD.AL2.NE, SD.AL2.MO, SD.V.MO ). In order to determine the Suspicion Score of MDS (SS-MDS), the 10 selected parameters were weighted during split sampling strategy by logistic regression. After repeat of 10,000 split-samples, the SS-MDS determined using weighted parameters was validated with average efficiency of 92.3%. For each parameter, the median of weighting coefficients was used in the mathematical model: "SS-MDS = ΣCi.Pi + intercept" with "Ci: weighting coefficient of parameter i" and "Pi: parameter i value". On the whole cohort, SS-MDS induced "MDS" flag for 11 MDS patients (red points in the Figures) for which conventional CBC algorithms failed to generate flag spreading peripheral blood smear. By fixing the threshold at -1.5, the sensitivity and specificity of SS-MDS were 100% and 92%, respectively. Moreover, the positive and negative predictive values were 93.5% and 100%, respectively. Conclusions The incidence of MDS increases with aging and the early diagnosis enables optimal care of these diseases. The Beckman-Coulter DxH 800 HematologyAnalyzer is widely used over the world. We propose in this study the clinical use of 10 unexploited "research parameters" to early detect subclinical MDS by selective triggering of blood smear examination. A prospective/multicentric study will allow the optimization of SS-MDS. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

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

2019 ◽  
Vol 7 (6) ◽  
pp. 2052
Author(s):  
Vineet Chaturvedi ◽  
Abdul Mabood ◽  
Shalini Gupta ◽  
Shivani Gupta ◽  
Kiran K. S. ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Peripheral Blood ◽  
Blood Smear ◽  
Peripheral Blood Smear ◽  
Mean Value ◽  
Good Precision ◽  
Thrombocyte Count ◽  
Automated Method ◽  
Hematology Analyzer ◽  
Automated Hematology Analyzer

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.

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