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DOI: 10.1055/s-0044-1788775
A Comparative Study of Peripheral Smear Findings with RBC Indices and Automated Analyzer Generated RBC Histograms in the Diagnosis of Anemia's
Abstract
Introduction The red blood cell (RBC) indices generated by cell counters help in the morphological classification of anemia. The importance of microscopic examination of peripheral blood smears (PBSs) stained by Leishman stain cannot be used alone when it comes to interpretation of the underlying cause of anemia. Hence, all three RBC histograms, indices, and microscopic examination of PBSs are very essential for a complete assessment of anemia.
Aims and Objectives To diagnose the type of anemia by examination of PBSs, automated cell-generated RBC histograms, and RBC indices and to compare and correlate the findings of RBC indices and automated cell-generated RBC histograms with PBS examination.
Materials and Methods This was a prospective comparative study done on 500 cases of anemia for a period of 5 months from August 2023 to December 2023 in a rural tertiary care teaching hospital and all the patients' RBC indices, RBC histogram findings, and PBS findings were noted and analyzed.
Results Among 500 samples, normocytic normochromic anemia consists of the majority of the cases 272 (54.4%), followed by microcytic hypochromic anemia cases 183 (36.6%), macrocytic anemia cases 27 (5.4%), normocytic hypochromic anemia were 10 (2%) cases, and dimorphic were 8 cases (1.6%). When compared with RBC histogram, 265 (53.0%) cases showed normal bell-shaped curve, 188 (37.6%) cases showed left shift, 27 (5.4%) cases showed broad based curve, 10 (2%) cases showed right shift, and 10 (2%) cases showed bimodal curve suggesting normocytic normochromic, microcytic hypochromic, normocytic hypochromic anemia, macrocytic, and dimorphic anemia, respectively.
Conclusion This study showed a well correlation in the findings of the automated hematology analyzer with the microscopic examination. Histogram alone could be used as a screening method but when combined with RBC indices and PBS findings, they act as useful supplements and by correlating findings of all three, we could diagnose the majority of anemia.
Publikationsverlauf
Artikel online veröffentlicht:
31. Juli 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Rajalakshmy P, Lokeshmaran A. Comparison of cyanmethemoglobin method and digital haemometer in measuring haemoglobin. Int J Med Biomed Stud 2019; 3 (05) 66-70
- 2 Singh T. Atlas and Text of Hematology. 4th ed.. India: Avichal Publishing Company; 2018: 65
- 3 Sullivan E. Hematology analyzer: from workhorse to thoroughbred. Lab Med 2006; 37 (05) 273-278
- 4 Kakkar N, Makkar M. Red cell cytograms generated by an ADVIA 120 automated hematology analyzer: characteristic patterns in common hematological conditions. Lab Med 2009; 40 (09) 549-555
- 5 Radtke H, Meyer T, Kalus U. et al. Rapid identification of iron deficiency in blood donors with red cell indexes provided by Advia 120. Transfusion 2005; 45 (01) 5-10
- 6 Marković M, Majkić-Singh N, Subota V, Mijusković Z. Reticulocyte hemoglobin content in the diagnosis of iron deficiency anemia. Clin Lab 2004; 50 (7-8): 431-436
- 7 Garg M, Gitika G, Sangwan K. Comparison of automated analyzer generated red blood cell parameters and histogram with peripheral smear in the diagnosis of anemia. Int J Contemp Med Res 2019; 6 (08) 111-116
- 8 Lin TF, Huang JN, Cash HL. Investigation of pediatric anemia in the Commonwealth of the Northern Mariana Islands. Matern Child Health J 2019; 23 (03) 416-421
- 9 Dhabangi A, Idro R, John CC. et al. Risk factors for recurrent severe anemia among previously transfused children in Uganda: an age-matched case-control study. BMC Pediatr 2019; 19 (01) 27-31
- 10 Karakochuk CD, Hess SY, Moorthy D. et al; HEmoglobin MEasurement (HEME) Working Group. Measurement and interpretation of hemoglobin concentration in clinical and field settings: a narrative review. Ann N Y Acad Sci 2019; 1450 (01) 126-146
- 11 Gupta A, Gupta P, Bhagat VM. Interpretation of histograms and its correlation with peripheral smear findings. J Evol Med Dent Sci 2017; 6 (60) 4417-4420
- 12 Tatsumi N, Tsuda I, Akira F, Takubo T, Hayashi M, Matsumoto H. Principle of blood cell counter- development of electric impedance method. Sysmex J Int 1999; 9 (01) 8-20
- 13 Constantino BT. The red cell histogram and the dimorphic red cell population. Lab Med 2011; 42 (05) 300-308
- 14 Sandhya I, Muhasin T. Study of RBC histogram in various anemia. J Evol Med Dent Sci 2014; 3: 15521-15534
- 15 Rao BSS, Santhi V, Rao NM, Grandhi B, Reddy VLM, Siresala P. RBC histogram as supplementary diagnostic tool with peripheral smear examination in evaluating anemia. Ann Pathol Lab Med 2017; 4: 66-72
- 16 Meena H, Pruthviraj CS, Gupta R, Guru A, Sutrakar SK. Correlation of automated cell counter RBC histograms and peripheral smear in anemia typing. Asian j of med Sci 2023; 14 (02) 127-31
- 17 Dhakar DK, Rai NN. A comparative study of red cell histogram along with CBC parameters and peripheral blood smear in various anemias. Indian J Pathol Oncol 2023; 10 (02) 156-162
- 18 Agarwal A, Goel N, Goel S. Comparative study of automated cell counter histogram and peripheral blood smear in diagnosis of anemia. Indian J Appl Res 2023; 13 (03) 5-7
- 19 Samly SSM, Mohan RCP, Sivasankaran M, Sadasivan S. Comparison of hematological parameters with peripheral smear in anemia. International J Clini Diag Pathol 2019; 2 (01) 92-95
- 20 Jha DN, Chaudhary AK, Jana D. Comparative study of anemia cases based on peripheral blood smears and cell counter generated red cell indices. Int J Sci Res 2020; 9 (12) 32-34