Correlation of peripheral smear with RBC indices and RBC histogram in the diagnosis of anemia (original) (raw)
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Comparative Study of Peripheral Smear with RBC Indices and RBC Histogram in Diagnosis of Anemia
2019
Title: Comparative study of peripheral smear with RBC indices and RBC histogram in diagnosis of anemia. Aim: To compare and correlate between diagnoses of anemia made by peripheral smear examination with RBC indices and RBC histograms. Methods: 100 anemic patients having hemoglobin level of less than 11 gm/dl were taken into study. Complete blood count including hemoglobin, Total count, differential count, haematocrit value, RBC indices and histogram was obtained from Mindray BC 5300 automated analyser. Peripheral blood smear examination was done for every patient. Comparison between diagnosis by peripheral smear versus RBC histogram and indices was done. Results: Out of 100 cases, 18% were normocytic normochromic anemia, 62% microcytic hypochromic anemia, 6% macrocytic anemia and 14% dimorphic anemia by peripheral smear examination. In normocytic normochromic anemia on peripheral smear, 89% showed normal curve in histogram. Left shift was seen in 73% of microcytic hypochromic anemi...
Correlation of peripheral smear with RBC indices and RBC histograms in the diagnosis of anemia
IP Innovative Publication Pvt.Ltd, 2017
Introduction: RBC histogram with erythrocyte indices provide clue to the diagnosis of anemia .Along with Peripheral smear it is used to interpret the cause of anemia. Aim: To correlate peripheral smear findings with RBC histogram patterns and RBCs indices to provide a better approach in the diagnosis of anemia and analyse their limitations. Materials and Method: 500 anemic patients with haemoglobin levels of less than 11.5gm% on EDTA sample by Beckman coulter LH-780 were included in the present study, leukemia being excluded. An impression was made by examining Leishman stained peripheral smear without referring to the histogram. The RBC histogram and the RBC indices were analysed and the anemia categorised. The correlation between the diagnosis made by Peripheral smear Vs RBC histogram, indices was analysed using Cramer's V (0.523) and Kappa statistics for agreement between the two methods. Results: The 500 cases included 21.8%, 46%, 8.8%, 17.6% and 5.8% cases of normocytic normochromic, microcytic hypochromic, macrocytic, dimorphic and haemolytic anemia respectively by peripheral smear examination. Analysis by erythrocyte indices and histogram showed similar findings except in macrocytic, dimorphic and hemolytic anemia which were 15.6%, 15.8% and 0.8% respectively. The correlation between the diagnosis made by the two methods was statistically significant, p<0.0001 and the agreement between the two methods was moderate (0.518). Conclusion: RBC histogram and indices should be interpreted in the light of peripheral smear which is indispensable in hemolytic and dimorphic anemia. On the contrary, histogram gives information about subtle changes well in advance of numerical parameters and subjective evaluation.
Journal of Clinical and Basic Research, 2024
Background: Anemia is a significant health concern around the world, and it is particularly prevalent in developing nations like India. A red blood cell (RBC) histogram is a graphic representation of particle size distribution (cell frequencies vs size). The goal of this study was to examine various types of anemia in patients and compare RBC histograms and results from peripheral smears. Methods: The study involved a total of 600 anemic patients. A histogram was produced with the use of a 5-part differential automated analyzer, following the complete mixing of the 3 mL of the EDTA blood sample. Additionally, a peripheral smear was prepared simultaneously and stained using Giemsa stain per standard operating procedures (SOP). The peripheral smear findings were then correlated with the histogram charts from the cell counter, taking into account the relevant clinical history. Results: Out of 600 cases, 339 were females, with a female-to-male ratio of 1.3:1. The 56.2% showed moderate anemia, 31.3 % showed mild anemia, and 12.5 % showed severe anemia. Among the histogram patterns, 52.7% exhibited a left shift, 35.5% showed the normal curve, 8.6% showed a broad base curve, 1.8% showed a right shift, and 1.3% showed a bimodal curve. Blood samples were evaluated along with the corresponding peripheral smear findings. The type of anemia was diagnosed by peripheral smear. 32.8 % of the cases were normocytic normochromic anemia, and 57.0% were microcytic hypochromic anemia. Macrocytic anemia was observed only in 2.5 % of cases, and dimorphic anemia was observed only in 8.0 % of cases diagnosed with PBS. The majority of times, peripheral smear findings and histogram patterns corresponded in cases of normocytic normochromic, microcytic hypochromic, and macrocytic anemias. In 600 cases, 420 had typing findings that accorded with those of the 2 methods, while 180 had discordant typing. Conclusion: Through its graphical representation of anemia typing, the automated analyzer helps decrease the total burden; nonetheless, it should always be verified through microscopy. As a result, it is concluded that in the era of molecular analysis and automation, the histogram alone could be used as a screening method. When combined with PBS findings, they act as a useful supplement, and by correlating the results of both methods, we could diagnose the majority of anemias.
Birat Journal of Health Sciences
Introduction: Anemia is one of the common medical conditions prevalent in our society. The correct categorization of varying types of anemia is essential for therapeutic purposes. Various laboratory tests are done to find out its underlying cause, but peripheral smear (PS) study of red blood cells (RBCs) morphology is important along with study of red blood cell indices in the classification of anemia. Objectives: This study was done to evaluate RBC morphology on peripheral smear examination in patients of anemia and to compare these findings with cell counter generated red blood cells indices comprising of Mean corpuscular volume (MCV), Mean corpuscular hemoglobin concentration (MCHC) and Mean corpuscular hemoglobin (MCH) Methodology: Red blood cell morphology on peripheral blood smear was studied in 350 patients of anemia irrespective of age and gender received under six months duration from 1st January 2019 to 30 th June 2019 and findings were compared with cell counter gener...
Annals of Pathology and Laboratory Medicine, 2017
Background: Red blood cell(RBC) histogram provide an idea about morphological changes of red blood cells in hematological disorders. Peripheral smear examination findings are usually correlated with complete blood cell counts by automated analyzer. To known the utility and advantage of red cell histogram and correlation of microscopic examination of peripheral smear with automated histogram pattern. Methods: Blood sample was collected from 220 anemia patients in ethylene diamine tetra acetic acid (EDTA) tubes for peripheral smear examination and ran in Beckman coulter LH 780 automated hematology analyzer for obtaining histogram, complete blood count includes hemoglobin, total leucocyte count, Platelet count, red blood cell indices and red cell distribution width. This study was undertaken for a period of one month of November 2016 in department of pathology, central laboratory, narayana medical college & hospital, Nellore. Results: This study of histograms of 220 different types of anemia consisted predominantly females 154 (70%) , and males 64(30%). Maximum cases of anemia were noted in 30-40 years of age range. Microcytic hypo chromic anemia was the most common (63.63%) followed by normocytic normochromic anemia (19.4%), macrocytic hypochromic anemia (2.2%), dimorphic anemia (12.72%) and pancytopenia (1.8%). Left shifted curve and broad base mostly seen in microcytic anemia, right shift curve seen in macrocytic anemia and bimodal peak mostly seen in dimorphic anemia. Conclusion: Histogram can be used as an important screening test for hematology and can become a new parameter in the diagnosis of anemia though peripheral examination remains the definitive diagnostic test for evaluation.
Indian Journal of Pathology and Oncology, 2023
Introduction: The red blood cell (RBC) parameters generated by cell counters can aid in morphological categorization of anemia, the significance of microscopic analysis of peripheral blood smears (PBSs) cannot be overlooked when it comes to interpreting the underlying cause of anemia. Therefore, both RBC parameters and microscopic examination of PBSs are essential for a comprehensive assessment of anemia. Aims and Objective: This study aimed to evaluate and compare the results obtained through two different methods: examination of peripheral blood smears (PBS) and automated cell counter generated parameters. The objective was to identify any differences or similarities in the diagnostic outcomes produced by each method. Materials and Methods: Over the course of one year, from December 2020 to November 2021, a hospital-based, prospective study was conducted. The study aimed to evaluate and compare the PBS findings and RBC parameters and histograms generated by a cell counter in 1000 anemic patients. In a sample of 1000 cases, we compared the typing of anemia using an automated analyzer and peripheral smear examination. Out of these cases, 690 showed consistent typing results between the two methods, while 310 showed discordant typing. The automated analyzer diagnosed majority of cases 70.1% as microcytic anemia and Normocytic, dimorphic, and macrocytic cases were found in 13.5%, 7.8%, and 4.3% of cases, respectively. Additionally, a normal histogram was observed in 17.6% of cases. Conclusion: We have concluded that while the automated analyzer is useful in reducing the overall workload through its graphical representation of anemia typing, it should always be confirmed through microscopy. The automated analyzer is a helpful tool, it should not be relied upon solely for accurate anemia typing. Microscopy remains an essential method for confirming the results of automated analysis. Keywords: Anemia, Peripheral blood smear, Automated cell counter, Red blood cell.
International journal of scientific research, 2021
The complete blood count (CBC) including DLC are backbone of any laboratory evaluation and provide valuable information to diagnose anaemia, acute and chronic illness, white cell disorder, leukemia and platelet disorders. During past 25 years blood cell analysis has progressed from manual procedures to highly automated instruments (2). In fully automated analyzers additional information in form of histogram charts are displayed which provide information about greater number of variables simultaneously.
INTRODUCTION Peripheral blood smear (PBS) examination is a part of the routine work of every laboratory. The manual examination of these images is tedious, time consuming and suffers from interobserver variation. This has motivated researchers to develop different algorithms and methods to automate PBS image analysis. The automated hematology analyzers give more accurate and <1% coefficient of variation for the RBC indices and hence have replaced the manual methods. Thus we can definitely conclude that the hematology analyzers definitely have a potential to replace peripheral blood smear examination. 1 The expertise needed to see the PBS is definitely far more than that needed to run the analyzers. Moreover there is intra and inter observer variation in morphological typing of anemia based on PBS examination. The additional PBS review performed by hematologist hardly ever provided unique information and provided incremental helpful information in only 4% of the cases. 2 Cell counting with these instruments is rapid, objective, statistically significant (8000 or more cells are counted) and not subject to the distributional bias of the manual count. Hence automated instruments increase accuracy, speed of analysis, minimizes levels of human manipulation for test entry, sampling, sample dilution and ABSTRACT Background: The aims and objectives of present study was to correlate typing of anemia based on RBC indices obtained from an automated analyzer with peripheral blood smear (PBS) examination and also to find out whether the number of PBS examination can be reduced with the help of automated hematology analyzer. Methods: A total of 2500 blood samples showing anemia as per WHO reference range were collected in central pathology lab of SVBP Hospital attached to L.L.R.M. Medical College, Meerut, Uttar Pradesh, India over a period of one year. Samples were reported by auto-analyzer and PBS examination simultaneously. Results: Out of total 2500 cases, there were 1623 females (64.9%) and 877 males (35.1%) with male: female ratio 0.54:1. By auto-analyzer and PBS examination, MCHC anemia (49.8%) was the commonest anemia followed by NCNC anemia (36.5%) and Macrocytic anemia (4.2%). Discordant typing of anemia between two methods was found in 284 (11.4%) cases only. These cases were diagnosed as normocytic normochromic (NCNC) anemia with raised RDW by autoanalyzer while as Dimorphic Anemia (DA) on PBS examination. Also morphological changes such as RBC inclusions, spherocytes, RBC fragments, schistocytes, nucleated RBCs were seen only on PBS examination. Conclusions: The Study concluded that even today PBS examination is very important and cannot be totally replaced by automated analyzer and both methods are complementary to each other.
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.9\_Sep2017/IJHSR\_Abstract.03.html, 2017
Background: Anemia is defined as a decrease in the total amount of Red Blood Cells (RBC) or Hemoglobin in the blood or lowered ability of the blood to carry Oxygen .There are many classifications of anemia but clinically useful approach is alterations in Red Cell morphology including the size and amount of hemoglobin in each cell. According to the WHO, there are two billion people with anemia in the world and half of the anemia is due to iron deficiency. Young children and women of childbearing age are the most affected one. The aim of the study was to assess the hematological parameters along with peripheral blood examination to evaluate the type, severity and prevalence of anemia in various age groups. cases were studied including outdoor as well as indoor. The samples for test were collected in EDTA tube. The slides for peripheral blood examination were prepared and stain with Giemsa .The sample were run in automated cell counter for hematological parameters and RBC indices. Results: In our study out of 1140 cases 52.63% were male and 47.36% were female and commonest group 46.14% affected were adults followed by the patients in the third decade 20.35%. Results showing high proportion of microcytic hypochromic anemia and their association with women following menarche period indicating iron deficiency as a main cause. Microcytic Hypochromic anemia was commonest morphologically classified anemia 49.10% of which, majority had moderate type 64.47% and majority are females and children followed by normocytic normochromic anemia accounting 40.01% and majority of which had mild type of anemia 62.52% and the predominant age group in this category was elderly. Macrocytic anemia 12.54%does not show any significant variation with severity and age group and only 51 had dimorphic anemia in which 64.7% had mild type. conclusion: In different age group the prevalence and the severity of various types of anemia is different, which is because of different etiology. The prevalence of anemia increases with age and is associated with chronic diseases, inflammation, nutritional deficiencies and other conditions such as infection, reduction in bone marrow response. As a result, a diagnosis of anemia warrants adequate clinical attention, to find out the cause, type, severity which provides basis treatment in anemic.