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Mohammadi M, Ghazizadeh H, Mohammadi-Bajgiran M, Kathryn Bohn M, Yaghooti-Khorasani M, Kamel Khodabandeh A, Steele S, Torabzadeh Khorasani N, Ferns GA, Boskabadi H, Esmaily H, Adeli K, Assaran Darban R, Ghayour-Mobarhan M. Pediatric reference intervals for hematology parameters in healthy infants and young children in Iran. Int J Lab Hematol 2023; 45:845-852. [PMID: 37442636 DOI: 10.1111/ijlh.14132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Defining accurate age- and sex-specific reference intervals (RIs) for hematology parameters, especially for the pediatric population, is important for making an appropriate clinical diagnosis. To address gaps, we established age-specific RIs for 11 hematologic parameters in Iranian children younger than 30 months for the first time. METHODS Fresh whole blood samples collected from a total of 344 participants (males: 158 and females: 186) ages 3 days to 30 months, with a mean age of 12.91 ± 7.15 months, were recruited from healthcare centers in Mashhad, Iran. Hematologic parameters, including complete blood count (CBC), were analyzed on the Sysmex auto-analyzer system (KX-21 N). RIs were calculated with 90% confidence intervals using the direct method based on CLSI Ep28-A3 and C28-A3 guidelines. RESULTS None of the CBC parameters required sex partitioning. Of 11 CBC parameters, six required age partitions of 3 days-<4 months, 4-<10, 10-<15, and 4-<30 months. Five parameters (i.e., white blood cell count, mean corpuscular hemoglobin concentration, mean platelet volume, red cell distribution width, and platelet distribution width) did not demonstrate age-specific changes. RIs of red blood cell count and hematocrit, as well as hemoglobin, increased with age, while mean corpuscular volume, mean corpuscular hemoglobin, and platelet count, decreased with age. CONCLUSION In this study, we established RIs for 11 hematology parameters in young children. Age partitioning was required for six parameters demonstrating marked changes during the early period of growth and development and necessitating the use of pediatric-specific reference standards.
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Affiliation(s)
- Maliheh Mohammadi
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Hamideh Ghazizadeh
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mohammadi-Bajgiran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mary Kathryn Bohn
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Canada
| | - Mahdiyeh Yaghooti-Khorasani
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atieh Kamel Khodabandeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shannon Steele
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Canada
| | | | - Gordon A Ferns
- Division of Medical Education, Falmer, Brighton & Sussex Medical School, Brighton, UK
| | - Hassan Boskabadi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical sciences, Mashhad, Iran
| | - Khosrow Adeli
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Canada
| | - Reza Assaran Darban
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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Badakhshan SN, Ghazizadeh H, Mohammadi‐Bajgiran M, Esmaily H, Khorasani MY, Bohn MK, Pashirzad M, Khodabandeh AK, Zadeh SG, Alami‐Arani I, Rahimi H, Ferns GA, Boskabadi H, Assaran‐Darban R, Adeli K, Ghayour‐Mobarhan M. Age-specific reference intervals for liver function tests in healthy neonates, infants, and young children in Iran. J Clin Lab Anal 2023; 37:e24995. [PMID: 38087776 PMCID: PMC10756939 DOI: 10.1002/jcla.24995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/13/2023] [Accepted: 11/26/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND The reference intervals (RIs) for liver function tests (LFTs) were determined in Iranian children for the first time. METHODS A total of 344 healthy pediatrics aged 3 days to 30 months old were recruited. Serum levels of ALT, AST, ALP, direct bilirubin, and total bilirubin were measured. RIs were determined using CLSI Ep28-A3 guidelines. RESULTS All analytes demonstrated age-specific differences except AST. ALT and ALP demonstrated significantly elevated levels in infants 0 to <5 months relative to the remainder of the age range. Direct and total bilirubin demonstrated markedly elevated levels in early life with mean of 0.28 mg/dL and 1.64 mg/dL observed for direct and total bilirubin, respectively, decreasing by ~50% in the adjacent partition. CONCLUSION These novel data will help improve the clinical interpretation of biochemical test results in young Iranian neonates and children and can be of value to clinical laboratories with similar populations.
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Affiliation(s)
| | - Hamideh Ghazizadeh
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory MedicineThe Hospital for Sick ChildrenTorontoOntarioCanada
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Maryam Mohammadi‐Bajgiran
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Habibollah Esmaily
- Social Determinants of Health Research CenterMashhad University of Medical SciencesMashhadIran
- Department of Biostatistics, School of HealthMashhad University of Medical SciencesMashhadIran
| | - Mahdiyeh Yaghooti Khorasani
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Mary Kathryn Bohn
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory MedicineThe Hospital for Sick ChildrenTorontoOntarioCanada
- Department of Laboratory Medicine & PathobiologyUniversity of TorontoTorontoOntarioCanada
| | - Mehran Pashirzad
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
- Department of Clinical Biochemistry, School of MedicineMashhad University of Medical ScienceMashhadIran
| | - Atieh Kamel Khodabandeh
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Sara Ghazi Zadeh
- Department of BiologyMashhad Branch, Islamic Azad UniversityMashhadIran
| | - Iman Alami‐Arani
- Department of BiologyMashhad Branch, Islamic Azad UniversityMashhadIran
| | - Hamidreza Rahimi
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Gordon A. Ferns
- Brighton & Sussex Medical School, Division of Medical EducationFalmerBrightonUK
| | - Hassan Boskabadi
- Department of Pediatrics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Khosrow Adeli
- CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory MedicineThe Hospital for Sick ChildrenTorontoOntarioCanada
- Department of Laboratory Medicine & PathobiologyUniversity of TorontoTorontoOntarioCanada
| | - Majid Ghayour‐Mobarhan
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
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