scholarly journals Ekstrak Betasianin dari Umbi Bit (Beta vulgaris) sebagai Pewarna Alami pada Sediaan Apusan Darah Tepi

2021 ◽  
Vol 6 (2) ◽  
pp. 152-160
Author(s):  
Islawati ◽  
Asriyani Ridwan ◽  
Rahmat Aryandi
Keyword(s):  
Beta Vulgaris ◽  
Peripheral Blood ◽  
Gold Standard ◽  
Blood Cells ◽  
Blood Smear ◽  
Venous Blood ◽  
Peripheral Blood Smear ◽  
Natural Dye ◽  
Cell Nuclei

ABSTRAK Morfologi sel berupa eritrosit, trombosit dan leukosit merupakan bagian dari pemeriksaan Apusan Darah Tepi (ADT). Pemeriksaan ini mampu mengindetifikasi jenis dan jumlah dari leukosit dan trombosit bahkan mampu mengetahui adanya parasite. Di Indnesia yang memiliki iklim tropis, pewarnaan yang sering digunakan adalah pewarnaan Romanowsky yakni pewarnaan dengan menggunakan pewarnaan wright, giemsa, atau bahkan kombinasi dari kedua pewarnaan tersebut. Kualitas dari pewarnaan apusan darah tepi dapat dinilai dari morfologi eosinophil. Hal ini disebabkan karena kekhasan dari eosinophil serta jumlah yang cukup banyak dan mudah diamati. Selain itu, jaminan dari kevalidan suatu pemeriksaan ADT adalah kualitas dari hasil pewarnaannya. Tujuan dari penelitian ini adalah teramatinya morfolofi dari sel darah dari sediaan apusan darah tepi dengan menggunakan ekstrak betasianin dari umbi bit (Beta vulgaris) sebagai bahan pewarna alami pengganti giemsa. Jenis penelitian berupa eksperimen laboratory dengan metode perbandingan hasil pengamatan terhadap morfologi sel darah yang berupa eritrosit, trombosit dan leukosit dengan menggunakan giemsa sebagai gold standard dan ekstrak betasianin sebagai pewarna alami dari umbi bit. Penelitian ini menggunakan sampel darah vena yang diambil dan ditampung pada tabung EDTA lalu dibuat dalam bentuk sediaan apusan darah. Hasil pewarnaan dengan menggunakan giemsa menunjukkan granula terlihat cukup jelas dan terlihat merah muda dengan inti sel berwarna biru keunguan. ekstrak betasianin menunjukkan bahwa kualitas pewarnaan pada leukosit dan trombosit kurang baik dan eritrosit memiliki kualitas pewarnaan yang cukup baik dengan memperlihatkan warna oranye yang cukup jelas. Sehingga dapat ditarik kesimpulan bahwa ekstrak betasianin dari umbi bit dapat dijadikan sebagai alternative pewarna alami untuk sel eritrosit dari sediaan apusan darah tepi.   Kata Kunci: Betasianin, Umbi Bit, Eritrosit, Pewarnaan   ABSTRACT   Morphology cell in the form of erythrocytes, platelets and leukocytes is part of the peripheral blood smear (ADT) examination. This examination is able to identify the type and number of leukocytes and platelets and is even able to detect the presence of parasites. In Indonesia, which has a tropical climate, the coloring that is often used is Romanowsky staining, namely staining using wright, Giemsa, or even a combination of the two colorings. The quality of the staining of the blood smear can be assessed from the morphology of the eosinophils. This is due to the uniqueness of eosinophils and their large number and easy to observe. In addition, the guarantee of the validity of an ADT examination is the quality of the staining results. The purpose of this study was to observe the morphology of blood cells from peripheral blood smears using betacyanin extract from beetroot (Beta vulgaris) as a natural dye substitute for Giemsa. The type of experimental research is in the form of a laboratory with a comparison method of observations on the morphology of blood cells in the form of erythrocytes, platelets and leukocytes using Giemsa as the gold standard and betacyanin extract as a natural dye from beetroot. This study used venous blood samples taken and stored in an EDTA tube and then made in the form of a blood smear. Staining results using Giemsa showed the granules were quite clear and looked pink with purplish-blue cell nuclei. Betacyanin extract showed that the quality of staining on leukocytes and platelets was not good and erythrocytes had a fairly good staining quality with a fairly clear color range. So it can be concluded that betacyanin extract from beetroot can be used as a natural alternative dye for erythrocyte cells from peripheral blood smear preparations.   Keywords: Betacyanin, beetroot, erythrocytes, staining

Development of a robust algorithm for detection of nuclei of white blood cells in peripheral blood smear images

2019 ◽  
Vol 78 (13) ◽  
pp. 17879-17898 ◽  
Author(s):  
Roopa B. Hegde ◽  
Keerthana Prasad ◽  
Harishchandra Hebbar ◽  
Brij Mohan Kumar Singh
Keyword(s):  
Peripheral Blood ◽  
Blood Cells ◽  
Blood Smear ◽  
White Blood Cells ◽  
Peripheral Blood Smear ◽  
Robust Algorithm

Convex Hull Based Detection of Overlapping Red Blood Cells in Peripheral Blood Smear Images

2015 ◽  
pp. 51-53 ◽  
Author(s):  
Feminna Sheeba ◽  
Robinson Thamburaj ◽  
Joy John Mammen ◽  
Mohan Kumar ◽  
Vansant Rangslang
Keyword(s):  
Convex Hull ◽  
Red Blood Cells ◽  
Peripheral Blood ◽  
Blood Cells ◽  
Blood Smear ◽  
Peripheral Blood Smear

Morphological Changes of Red Blood Cells in Peripheral Blood Smear of Patients with Pregnancy-related Hypertensive Disorders

2015 ◽  
Vol 46 (6) ◽  
pp. 479-483 ◽  
Author(s):  
Jorge Daniel Hernández Hernández ◽  
Onésimo Rangel Villaseñor ◽  
Javier Del Rio Alvarado ◽  
Roberto Ortega Lucach ◽  
Arturo Zárate ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Peripheral Blood ◽  
Blood Cells ◽  
Blood Smear ◽  
Morphological Changes ◽  
Peripheral Blood Smear ◽  
Hypertensive Disorders

scholarly journals Dehydrated Hereditary Stomatocytosis: A Rare Inherited Hemolytic Anemia

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4148-4148
Author(s):  
Farah Shaukat ◽  
Zeba Singh ◽  
Hira Latif
Keyword(s):  
Iron Overload ◽  
Red Blood Cells ◽  
Hemolytic Anemia ◽  
Peripheral Blood ◽  
Blood Cells ◽  
Blood Smear ◽  
Peripheral Blood Smear ◽  
Blood Transfusions ◽  
Erythroid Progenitor ◽  
Distribution Width

Abstract Background: Dehydrated hereditary stomatocytosis (DHSt), also known as hereditary xerocytosis, is a rare congenital hemolytic anemia with an autosomal dominant inheritance. It is often misdiagnosed for other hemolytic conditions, such as hereditary spherocytosis. Herein, we present the case of a young female presenting with hemolytic anemia, who was found to have a mutation in PIEZO1 gene and was subsequently diagnosed with DHSt. Case Presentation: A 39-year-old woman of Asian origin presented to the hematology clinic for evaluation of anemia diagnosed on blood work performed by primary care physician for symptoms of fatigue. She was adopted and had no information about her family history. A complete blood count revealed: hemoglobin 8.2 g/dL, mean corpuscular volume (MCV) 121.6 fL, absolute retic counts 0.08 M/mcL, lactate dehydrogenase 851 units/L and a negative coombs test. Iron profile revealed iron saturation 85% and ferritin 1961.4 ng/mL (see table 1 for laboratory work up). The peripheral blood smear showed anisopoikilocytosis, macrocytes, spherocytes and several stomatocytes along with polychromatophils. An ultrasound of the abdomen was subsequently performed, and which revealed hepatomegaly and biliary stones. Enzyme assay for glucose-6-phosphate dehydrogenase and flow cytometry for paroxysmal nocturnal hemoglobinuria were also sent and were negative. Red blood cells osmotic fragility was decreased. The bone marrow biopsy showed full spectrum trilineage hematopoiesis with no mutations on molecular testing. Based on the blood smear and clinical presentation, a diagnosis of DHSt was suspected. Genetic testing was performed and which revealed Sc.2842C>T; p.Arg948Cys mutation in the PIEZO1 gene by massively parallel sequencing and confirmation by Sanger sequencing. This confirmed the diagnosis of DHSt. Patient was started on high dose folic acid with improvement in her hemoglobin in one month. She did not require any blood transfusions. MRI liver T2* scan measured quantitative liver iron of 31 mM/g, which was at the high normal range. Discussion: DHSt is caused by gain of function mutation in PIEZO1 gene or KCCN4 gene which encode the transmembrane cation ion channel and Gardo's channel respectively on red blood cell membrane. This results in delayed inactivation of the channel. The disease presents as a spectrum from asymptomatic anemia to massive hemolysis, and many patients present later in life. Patients may manifest clinical signs of jaundice, pallor, fatigue, splenomegaly, gallstones and iron overload. Labs are typically significant for elevation in mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW) and MCV, with classic slit cells red blood cells seen on peripheral blood smear (see image 1). PIEZO1 is expressed early in erythroid progenitor cells and may delay erythroid differentiation and reticulocyte maturation, which may be the cause of low reticulocyte count such as in our patient. While treatment is supportive with blood transfusions, only a minority of DHSt patients ever require regular transfusions. Interestingly, hyperferritinemia, high transferrin saturation or clinical iron overload are quite frequent in DHSt and iron chelation is recommended. Splenectomy is contraindicated due to increased risk of thrombosis. Conclusions: DHSt as a rare inherited hemolytic anemia and its diagnosis warrants maintaining a high index of clinical suspicion based on supportive laboratory findings. Diagnosis involves thorough testing earlier in the disease as patients may be asymptomatic until adulthood. Delaying the diagnosis may lead to severe iron overload and consequent organ damage. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Red Blood Cell Morphological Changes and Enlarged Platelets Found in Idiopathic Multicentric Castleman Disease

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3795-3795
Author(s):  
Ayelet I Rubenstein ◽  
Sheila K Pierson ◽  
David C Fajgenbaum
Keyword(s):  
Autoimmune Diseases ◽  
Peripheral Blood ◽  
Blood Cells ◽  
Blood Smear ◽  
Laboratory Data ◽  
Peripheral Blood Smear ◽  
Castleman Disease ◽  
Giant Platelets ◽  
Multicentric Castleman Disease ◽  
First Time

Abstract BACKGROUND Idiopathic multicentric Castleman disease (iMCD) is a rare polyclonal lymphoproliferative disorder characterized by systemic inflammatory symptoms, cytopenias, generalized lymphadenopathy, and multiple organ system dysfunction. iMCD is subclassified into iMCD-TAFRO, with thrombocytopenia, anasarca, fever/elevated C-reactive protein, reticulin myelofibrosis/renal failure, and organomegaly, and iMCD-NOS (not otherwise specified), with high platelet counts and hypergammaglobulinemia. Despite recent diagnostic guidelines, iMCD diagnosis remains challenging because many of the histopathologic features and clinical/laboratory abnormalities are non-specific. Characterization of easily measurable findings from minimally invasive procedures, such as peripheral blood smear, could help to improve the accuracy of diagnosis as well as potentially providing insights into disease pathogenesis. Peripheral blood smears are often performed during routine clinical evaluation and enable morphologic evaluation of red blood cells (RBCs) and white blood cells (WBCs). In this study, we systematically characterized peripheral blood smear morphologic findings in iMCD for the first time. METHODS Peripheral blood smear morphologic findings in medical records from 68 iMCD patients, who were enrolled in an international registry for CD patients and had been confirmed to meet iMCD criteria by an expert panel, were reviewed and analyzed. Patients were also categorized into iMCD-TAFRO (N=39) or iMCD-NOS (N=29) based on clinical and laboratory data. Two-sample proportion tests were used to compare the frequency of features between iMCD-TAFRO and iMCD-NOS, when the abnormality was present in ≥ 5 subjects in both subtypes. P-value correction was not performed as findings are preliminary and hypothesis generating. RESULTS Among the 68 iMCD patients, average age was 35.8 years (14-61); 46% were female, 54% were male; racial distribution was 62% white; 10% Black; 15% Asian; 13% other. The most common peripheral blood smear findings across all iMCD patients included abnormalities in RBC size and color, with anisocytosis (58.8%), polychromasia (57.4%), hypochromia (55.9%), and microcytosis (50.0%) being the most prevalent findings in the overall cohort (Table 1). Other RBC abnormalities were observed but less frequently, including abnormalities in shape such as poikilocytosis (44.1%). Giant or large platelets were found in 47% of iMCD cases. Abnormalities in WBCs, including toxic granulation, atypical lymphocytes, and toxic vacuolization, were detected less frequently. When comparing the two clinical subtypes, patients with iMCD-TAFRO had more frequent anisocytosis (p=0.043), hypochromia (p=0.002), polychromasia (p=0.022), and giant/large platelets (p<0.001) versus iMCD-NOS. DISCUSSION Here, we have characterized peripheral blood morphologic abnormalities in iMCD for the first time. The most common findings in this cohort included abnormalities in RBC size and color. These abnormalities can be found in a number of conditions, including myelofibrosis, autoimmune diseases, and other inflammatory conditions. In iMCD, they are likely related to cytokine-driven anemia of chronic inflammation. The presence of large or giant platelets in nearly half of iMCD patients, with significantly more in iMCD-TAFRO than iMCD-NOS, is particularly notable since this has not been described in iMCD. These enlarged platelets, which can be found in immune thrombocytopenic purpura, myeloproliferative disorders, pseudothrombocytopenia, and inherited platelet disorders, may reflect hyperactivity of megakaryocytes and/or early release from the bone marrow in response to peripheral platelet sequestration. Though less common in this cohort, there are additional changes in RBC shape and WBC features that may be more specific to iMCD and potentially informative in increasing the index of suspicion for iMCD. These findings suggest that the peripheral blood smear may be able to support the diagnosis of iMCD and result in faster treatment administration. Future work is needed to determine whether the constellation of findings in the peripheral blood identified herein is unique to iMCD or seen in various other infectious, malignant, and autoimmune diseases. Figure 1 Figure 1. Disclosures Fajgenbaum: Pfizer: Other: Study drug for clinical trial of sirolimus; EUSA Pharma: Research Funding; N/A: Other: Holds pending provisional patents for 'Methods of treating idiopathic multicentric Castleman disease with JAK1/2 inhibition' and 'Discovery and validation of a novel subgroup and therapeutic target in idiopathic multicentric Castleman disease'.

scholarly journals Acquired Pelger-Huët anomaly in a patient treated with valganciclovir

2019 ◽  
Vol 12 (10) ◽  
pp. e230958 ◽  
Author(s):  
Elva Nieto-Borrajo ◽  
Alfredo Bermejo-Rodriguez
Keyword(s):  
Peripheral Blood ◽  
Blood Cells ◽  
Blood Count ◽  
Blood Smear ◽  
Complete Blood Count ◽  
White Blood Cells ◽  
Peripheral Blood Smear ◽  
Condensed Chromatin ◽  
Morphological Abnormalities

A follow-up blood count was performed on a 74-year-old woman diagnosed with colitis due to cytomegalovirus and under treatment with valganciclovir. The automated complete blood count revealed an abnormal white blood cells (WBC) scattergram together with WBC alert flags. The peripheral blood smear showed neutrophils with markedly hyposegmented nuclei or bilobed nuclei and very condensed chromatin or clumping chromatin all consistent with Pelger-Huët anomaly (PHA). We checked previous blood counts, ruling out an inherited PHA. We assessed the haematological, infectious and iatrogenic aetiologies for an acquired PHA. Once the valganciclovir treatment was completed and the drug was withdrawn, without changing the rest of the treatment, the morphological abnormalities of neutrophils were completely resolved. We conclude therefore that the acquired PHA presented by our patient is probably related to valganciclovir treatment.

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