1
|
Freitas FP, Reis J, Oliveira J, Veiga PM, Raquel Paiva A, Soares R. The dilution evaluation as a corrective measure for interference in the white blood cell scattergram in Beckman Coulter DxH 900. J Clin Lab Anal 2024; 38:e25007. [PMID: 38594837 PMCID: PMC11073809 DOI: 10.1002/jcla.25007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/15/2023] [Accepted: 01/07/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The Beckman Coulter DxH 900 is a haematological analyser capable of counting and sizing blood cells, and obtaining a complete blood cell count (CBC). This analyses different parameters of red blood cells (RBC), platelets and white blood cells/leukocytes. Some automated CBC counters present limitations due to specimen characteristics, abnormal cells or both factors. In the presence of abnormalities, the DxH 900 has a flagging system, warning the laboratory technician that something needs to be verified. In the present work, we evaluated samples from oncologic patients, presenting a population erroneously perceived as being lymphocytes. The most common explanations for this situation are RBC resistant to lysis or serum hyperbilirubinaemia. METHODS In an attempt to solve and understand what the cause of this problem might be, we diluted our samples (1:3) and analysed the serum total bilirubin. To identify cells' abnormalities, the samples were also analysed by manual DLC counts. During the study, we also checked the different flags presented by the equipment. RESULTS The results evidenced that the major interference was due to RBC lysis resistance, corresponding to 94.7% of the cases, while hyperbilirubinaemia was only present in 73.4%. Besides, we determined that some samples with normal bilirubin levels also presented interference, suggesting that hyperbilirubinaemia was not the main cause of the error. The most recurrent flag observed was "High event rate". CONCLUSION The dilution solved all of the observed interferences. The results between diluted and manual counts showed a strong correlation, leading us to introduce dilution in our laboratory routine.
Collapse
Affiliation(s)
- Filipa P. Freitas
- Clinical Pathology Service, Portuguese Institute of Oncology of Coimbra Francisco GentilEPECoimbraPortugal
| | - Jorge Reis
- Clinical Pathology Service, Portuguese Institute of Oncology of Coimbra Francisco GentilEPECoimbraPortugal
| | - Joana Oliveira
- Clinical Pathology Service, Portuguese Institute of Oncology of Coimbra Francisco GentilEPECoimbraPortugal
| | - Pedro Mota Veiga
- University of MaiaMaiaPortugal
- NECE – Research Center for Business SciencesUniversidade da Beira InteriorCovilhãPortugal
| | - Ana Raquel Paiva
- Clinical Pathology Service, Portuguese Institute of Oncology of Coimbra Francisco GentilEPECoimbraPortugal
| | - Rui Soares
- Clinical Pathology Service, Portuguese Institute of Oncology of Coimbra Francisco GentilEPECoimbraPortugal
- Institute of Medical Microbiology, Faculty of MedicineUniversity of CoimbraCoimbraPortugal
| |
Collapse
|
2
|
Collins A, Swann JW, Proven MA, Patel CM, Mitchell CA, Kasbekar M, Dellorusso PV, Passegué E. Maternal inflammation regulates fetal emergency myelopoiesis. Cell 2024; 187:1402-1421.e21. [PMID: 38428422 PMCID: PMC10954379 DOI: 10.1016/j.cell.2024.02.002] [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: 09/15/2023] [Revised: 12/03/2023] [Accepted: 02/02/2024] [Indexed: 03/03/2024]
Abstract
Neonates are highly susceptible to inflammation and infection. Here, we investigate how late fetal liver (FL) mouse hematopoietic stem and progenitor cells (HSPCs) respond to inflammation, testing the hypothesis that deficits in the engagement of emergency myelopoiesis (EM) pathways limit neutrophil output and contribute to perinatal neutropenia. We show that fetal HSPCs have limited production of myeloid cells at steady state and fail to activate a classical adult-like EM transcriptional program. Moreover, we find that fetal HSPCs can respond to EM-inducing inflammatory stimuli in vitro but are restricted by maternal anti-inflammatory factors, primarily interleukin-10 (IL-10), from activating EM pathways in utero. Accordingly, we demonstrate that the loss of maternal IL-10 restores EM activation in fetal HSPCs but at the cost of fetal demise. These results reveal the evolutionary trade-off inherent in maternal anti-inflammatory responses that maintain pregnancy but render the fetus unresponsive to EM activation signals and susceptible to infection.
Collapse
Affiliation(s)
- Amélie Collins
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Division of Neonatology-Perinatology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA.
| | - James W Swann
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Melissa A Proven
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Chandani M Patel
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Carl A Mitchell
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Monica Kasbekar
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Division of Hematology/Oncology, Department of Internal Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Paul V Dellorusso
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Emmanuelle Passegué
- Columbia Stem Cell Initiative, Columbia University Irving Medical Center, New York, NY 10032, USA; Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA.
| |
Collapse
|
3
|
Cai Q, Lin H, Guo P. Performance evaluation of PLT-H (hybrid-channel platelet) under various interferences and application studies for platelet transfusion decisions. Platelets 2023; 34:2287064. [PMID: 38031975 DOI: 10.1080/09537104.2023.2287064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
The hybrid-channel platelet counting method (PLT-H) is a new platelet counting technique proposed by Mindray of China. In this study, we aimed to evaluate the accuracy of this technique in various situations and its reliability in platelet transfusion decision-making. A total of 378 venous blood samples were tested. Using the immunological PLT counting method recommended by the International Council for Standardization in Hematology as the reference method (PLT-IRM), Passing-Bablok regression and Bland-Altman analysis were performed on the PLT-H results. The anti-interference performance of PLT-H under different interference levels was explored using intergroup comparisons, and confusion matrices were analyzed at various transfusion cutoff values. In the absence of interference, there was a strong correlation between PLT-H and PLT-IRM (r = 0.993, 95% CI: 0.990-0.996). Under various interference conditions, the correlation between PLT-H and PLT-IRM was between 0.963 and 0.992, with an average deviation of -14.56 to -2.02. The performance of PLT-H against interference did not change significantly with increasing levels of small RBCs, large PLTs, and RBC fragments (P = .5704, 0.0832, 0.9893). In low-value samples (PLT <100 × 109/L), the coefficient of variation (CV) for PLT-H was less than 7.6%, regardless of the presence or absence of interfering substances. In addition, there was a high agreement between PLT-H and PLT-IRM (ICC = 0.972). Confusion matrice analysis at each medical decision level showed similarity to methods using the fluorescence channel (PLT-O) and superiority to the impedance channel (PLT-I). Compared with PLT-I, PLT-H has higher accuracy in PLT counting, stronger anti-interference ability, better performance in low-value samples at no extra economic cost and can be more useful for platelet transfusion decision-making. PLT-H is a novel method for platelet counting that offers higher accuracy, providing physicians with the ability to make better medical decisions, particularly in cases where values are low, or interference is present. As it does not require additional reagents, it is highly likely to replace PLT-I and become the mainstream method for platelet counting in the future.
Collapse
Affiliation(s)
- Qi Cai
- Clinical Laboratory, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Han Lin
- Clinical Laboratory, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Ping Guo
- Clinical Laboratory, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| |
Collapse
|
4
|
Rosetti M, Olivieri M, Polli V, Massari E, Monti M, Clementoni A, Libri V, Poletti G, Fasano T. Effects of the presence of fibrin strands on complete blood count parameters. Scand J Clin Lab Invest 2023; 83:620-621. [PMID: 38090770 DOI: 10.1080/00365513.2023.2292601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/05/2023] [Indexed: 01/25/2024]
Affiliation(s)
- Marco Rosetti
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Melania Olivieri
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Valentina Polli
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Evita Massari
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Marta Monti
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Alice Clementoni
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Virginia Libri
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Giovanni Poletti
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| | - Tommaso Fasano
- Clinical Pathology Unit, Hub Laboratory, AUSL della Romagna, Cesena, Italy
| |
Collapse
|
5
|
Turudic D, Dejanovic Bekic S, Mucavac L, Pavlovic M, Milosevic D, Bilic E. Case report: Autoimmune hemolytic anemia caused by warm and cold autoantibodies with complement activation-etiological and therapeutic issues. Front Pediatr 2023; 11:1217536. [PMID: 37794962 PMCID: PMC10546200 DOI: 10.3389/fped.2023.1217536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/01/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Research on mixed warm and cold autoantibodies in autoimmune hemolytic anemia (AIHA) targeting erythrocytes [red blood cells (RBCs)] and platelets is scarcely reported. Case presentation In this study, we present the case of a 5-year-old boy with positive direct [anti-IgG (1+), anti-IgG-C3d (3+)], and indirect antiglobulin (Coombs) tests. The RBCs were coated with polyspecific-positive, warm IgG autoantibodies alongside activated complement components. Plasma-containing immunoglobulin M (IgM) class autoantibodies were found in 1:64 titers with a wide temperature range of 4°C-37°C. The platelets were also coated with IgM autoantibodies. There was a reduction in the levels of the classical and alternative complement pathways, such as C3, C4, ADAMTS13 metalloprotease activity, factor H antigen, complement factor B antigen, and C1q antigen alongside the elevated sC5b-9 terminal complement complex. Hematuria and/or proteinuria, reduced diuresis, and elevated levels of serum creatinine were absent. The kidney ultrasound report was normal. A recent combination of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection was found. The first-line treatment consisted of intravenous methylprednisolone [4 mg/kg/body weight for the first 72 h (q12 h), followed by 2 mg/kg body weight for 21 consecutive days with a slow steroid reduction until plasmapheresis (PLEX)]. After the patient showed limited response to corticosteroid therapy, rituximab (375 mg/m2) was administered once a week (five doses in total), with vitamins B9 and B12. These strategies also showed limited (partial) therapeutic benefits. Therefore, the treatment was switched to PLEX (five cycles in total) and intravenous immunoglobulin (IVIg) (1 g/kg/5 days). This combination significantly improved RBC count and platelet levels, and C3 and C4 levels returned to normal. A follow-up of 2.5 years after treatment showed no sign of relapse. A genetic analysis revealed a rare heterozygous intronic variation (c.600-14C > T) and heterozygous Y402H polymorphism of the CFH gene. c.600-14C > T mutation was located near the 5' end of exon 6 in the gene encoding the complement C3 protein of unknown significance. We presumed that the complement regulators in our patient were sufficient to control complement activation and that complement blockade should be reserved only for devastating, life-threatening complement-related multiorgan failure. Conclusion We believe that EBV and CMV triggered AIHA, thus activating the complement cascade. Hence, we used corticosteroids, rituximab, vitamins B9 + B12, PLEX, and fresh frozen plasma (FFP) as treatment. Final remission was achieved with PLEX and FFP. However, an additional late effect of B12 rituximab and the disappearance of long-lived circulating plasma cells should not be completely ignored. Complement activation with a genetic background should be assessed in severe warm and cold hemolytic anemias caused by autoantibodies.
Collapse
Affiliation(s)
- Daniel Turudic
- Department of Pediatric Hematology and Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Sara Dejanovic Bekic
- Department of Pediatric Hematology and Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lucija Mucavac
- Department of Pediatric Hematology and Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Maja Pavlovic
- Department of Pediatric Hematology and Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Danko Milosevic
- Croatian Academy of Medical Sciences, Zagreb, Croatia
- Department of Pediatrics, Zabok General Hospital and the Croatian Veterans Hospital, Zabok, Bračak, Croatia
| | - Ernest Bilic
- Department of Pediatric Hematology and Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
6
|
Collins A, Swann JW, Proven MA, Patel CM, Mitchell CA, Kasbekar M, Dellorusso PV, Passegué E. Maternal IL-10 restricts fetal emergency myelopoiesis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.13.557548. [PMID: 37745377 PMCID: PMC10515963 DOI: 10.1101/2023.09.13.557548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Neonates, in contrast to adults, are highly susceptible to inflammation and infection. Here we investigate how late fetal liver (FL) mouse hematopoietic stem and progenitor cells (HSPC) respond to inflammation, testing the hypothesis that deficits in engagement of emergency myelopoiesis (EM) pathways limit neutrophil output and contribute to perinatal neutropenia. We show that despite similar molecular wiring as adults, fetal HSPCs have limited production of myeloid cells at steady state and fail to activate a classical EM transcriptional program. Moreover, we find that fetal HSPCs are capable of responding to EM-inducing inflammatory stimuli in vitro , but are restricted by maternal anti-inflammatory factors, primarily interleukin-10 (IL-10), from activating EM pathways in utero . Accordingly, we demonstrate that loss of maternal IL-10 restores EM activation in fetal HSPCs but at the cost of premature parturition. These results reveal the evolutionary trade-off inherent in maternal anti-inflammatory responses that maintain pregnancy but render the fetus unresponsive to EM activation signals and susceptible to infection. HIGHLIGHTS The structure of the HSPC compartment is conserved from late fetal to adult life.Fetal HSPCs have diminished steady-state myeloid cell production compared to adult.Fetal HSPCs are restricted from engaging in emergency myelopoiesis by maternal IL-10.Restriction of emergency myelopoiesis may explain neutropenia in septic neonates. eTOC BLURB Fetal hematopoietic stem and progenitor cells are restricted from activating emergency myelopoiesis pathways by maternal IL-10, resulting in inadequate myeloid cell production in response to inflammatory challenges and contributing to neonatal neutropenia.
Collapse
|
7
|
Dai Q, Peng L, Shi R. Spurious low WBC count in the WNR channel of Sysmex XN-9000 hematology analyzer in a case with leukocyte aggregation. Clin Chem Lab Med 2023; 61:e131-e133. [PMID: 36639149 DOI: 10.1515/cclm-2022-1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023]
Affiliation(s)
- Qingkai Dai
- Department of Laboratory Medicine, Sichuan University West China Second University Hospital, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, P.R. China
| | - Luyun Peng
- Department of Laboratory Medicine, Sichuan University West China Second University Hospital, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, P.R. China
| | - Rui Shi
- Department of Laboratory Medicine, Sichuan University West China Second University Hospital, Chengdu, P.R. China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, P.R. China
| |
Collapse
|
8
|
Fernández Prendes C, Castro Castro MJ, Sánchez Navarro L, Rapún Mas L, Morales Indiano C, Arrobas Velilla T. Handling of lipemic samples in the clinical laboratory. ADVANCES IN LABORATORY MEDICINE 2023; 4:5-27. [PMID: 37359904 PMCID: PMC10197190 DOI: 10.1515/almed-2023-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/11/2022] [Indexed: 06/28/2023]
Abstract
Interferences in the clinical laboratory may lead physicians misinterpret results for some biological analytes. The most common analytical interferences in the clinical laboratory include hemolysis, icterus and lipemia. Lipemia is defined as turbidity in a sample caused by the accumulation of lipoproteins, mainly very-low density lipoproteins (VLDL) and chylomicrons. Several methods are available for the detection of lipemic samples, including the lipemic index, or triglyceride quantification in serum or plasma samples, or mean corpuscular hemoglobin (MCHC) concentration in blood samples. According to the European Directive 98/79/CE, it is the responsibility of clinical laboratories to monitor the presence of interfering substances that may affect the measurement of an analyte. There is an urgent need to standardize interference studies and the way interferences are reported by manufacturers. Several methods are currently available to remove interference from lipemia and enable accurate measurement of biological quantities. The clinical laboratory should establish a protocol for the handling of lipemic samples according to the biological quantity to be tested.
Collapse
Affiliation(s)
- Carla Fernández Prendes
- Laboratory Medicine Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
| | - María José Castro Castro
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
- Biochemistry Core, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Lourdes Sánchez Navarro
- Haematological Core, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Loreto Rapún Mas
- Haematological Core, Laboratori Clínic Territorial Metropolitana Sud, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Cristian Morales Indiano
- Laboratory Medicine Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
| | - Teresa Arrobas Velilla
- Laboratory of Nutrition and Cardiovascular Risk, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Workgroup of Lipoproteins and Cardiovascular Diseases, Spanish Society of Laboratory Medicine, Barcelona, Spain
| |
Collapse
|
9
|
Tariq S, Ismail D, Thapa M, Goriparthi L, Pradeep R, Khalid K, Cooper AC, Jean-Charles G. Chronic Obstructive Pulmonary Disease and Its Effect on Red Blood Cell Indices. Cureus 2023; 15:e36100. [PMID: 37065412 PMCID: PMC10097512 DOI: 10.7759/cureus.36100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) constitutes a set of heterogeneous symptoms affecting millions of people worldwide. The associated comorbidities developing in COPD involve dysregulation in physiological pathways resulting from systemic inflammation in respiratory airways. In addition to mentioning the pathophysiology, stages, and consequences of COPD, this paper also defines red blood cell (RBC) indices such as hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cell distribution width, and RBC count. It explains the role of RBC indices and RBC structural abnormalities with disease severity and exacerbations in COPD patients. Although many factors have been studied as a marker of morbidity and mortality for COPD patients, RBC indices have emerged as revolutionary evidence. Therefore, the effectiveness of evaluating RBC indices in COPD patients and their importance as a negative predictor of survival, mortality, and clinical outcomes have been debated through rigorous literature reviews. Furthermore, the prevalence, mechanisms of development, and prognosis of underlying anemia and polycythemia in COPD have also been evaluated, with anemia most significantly associated with COPD. Therefore, more studies should be conducted to address underlying anemia in COPD patients to lessen the severity and disease burden. Correcting the RBC indices in COPD patients remarkably impacts the quality of life and reduces in-patient admissions, healthcare resource utilization, and costs. Hence, it is noteworthy to understand the significance of considering RBC indices while dealing with COPD patients.
Collapse
|
10
|
Durrieu F. Evaluation of the WBC-differential flagging performances and accuracy of the HORIBA Yumizen H2500 cell counter in oncology patients from a single institution. Int J Lab Hematol 2023; 45:37-45. [PMID: 36351659 DOI: 10.1111/ijlh.13983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/30/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The Yumizen H2500 (YH2500) cell analyser was compared to the Pentra DX Nexus (both from HORIBA Medical) to evaluate the efficiency of the new YH2500 technology for the WBC-differential in samples from oncology patients with WBC-diff abnormalities. MATERIAL AND METHODS The 220 samples with slide review criteria on the Nexus were systematically analysed on the YH2500. The WBC-diff was compared to flow cytometry (FCM). The 100 additional samples with Monocyte/Neutrophil separation flags were evaluated. The flagging performance and the accuracy of the WBC-diff were analysed. RESULTS The YH2500 generated fewer flags than the Nexus (47.73% vs 66.64%; p < .0001), except for Monocyte/Neutrophil flag (15.5% vs. 2.7%; p < 0.0001). Overall performances were higher on the YH2500 (Sensitivity, 100 vs. 89.6%; Specificity 81.0% vs. 50.9%; PPV, 74.3% vs. 62.9%; NPV, 100% vs. 69.5%; Efficiency, 87.7% vs. 69.5%). YH2500 showed a statistically significant better correlation with FCM for the 6-part differential than the Nexus. On 134 samples with Monocyte/Neutrophil separation flag, it was shown that, in samples with less than 10% monocytes on the YH2500, the results of monocyte and neutrophil counts were comparable to the manual count, and that these samples did not need a slide review if no other main criterion for review was present. CONCLUSION The YH2500 demonstrated better performance characteristics than the previous cell counter, the Nexus. Its implementation in our laboratory routine work significantly improved the practice workflow, decreased the number of manual cell counts and increased the pertinence of slide review and reporting of the microscopic count.
Collapse
Affiliation(s)
- Françoise Durrieu
- Laboratory of Medical Biology, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France
| |
Collapse
|
11
|
Henry S, Gérard D, Salignac S, Perrin J. Optimizing the management of analytical interferences affecting red blood cells on XN-10 (Sysmex®). Int J Lab Hematol 2022; 44:1068-1077. [PMID: 36053968 PMCID: PMC9804823 DOI: 10.1111/ijlh.13951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/29/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Interferences on red blood cells (RBCs) measurement and the associated parameters in haematology analyzers are very common. Many sources of interferences are described but their management remains uncertain depending on the measurement system; we aimed at developing an optimized scheme allowing the accurate management of most interferences affecting RBCs, based on the alternative "optical" parameters from SYSMEX XN-10. METHODS Samples from 12 groups of relevant interferences were analysed and compared with a control group allowing (1) the determination of deviation thresholds beyond which an interference is likely, and (2) the development of two flowcharts for their subsequent management. These flowcharts were then evaluated among a bank of retrospective typical cases of interferences and in the routine flow of the laboratory. RESULTS After verifying the excellent agreement between standard and alternative parameters, the comparative study between analytical channels allowed to determine an acceptable deviation and then discriminate technical concerns caused by cold agglutinins, leukocytosis and plasma-related interferences. This led to the development of flowcharts ensuring the accurate management of these interferences, whether MCHC is <320 or >365 g/L. These proposed flowcharts allowed the correction of 63/65 historical confirmed interferences cases (97%). Furthermore, they corrected 18 results among 901 unselected prospective samples. CONCLUSION The resulting flowcharts allow a relevant correction for most common interferences affecting RBCs and are now definitively included in the routine analytical management and will be directly incorporated in the middleware of the laboratory.
Collapse
Affiliation(s)
- Sylvain Henry
- INSERM, UMR_S 1116Vandœuvre‐lès‐NancyFrance,CHRU Nancy, Service d'hématologie biologique, Pôle LaboratoiresNancyFrance
| | - Delphine Gérard
- INSERM, UMR_S 1116Vandœuvre‐lès‐NancyFrance,CHRU Nancy, Service d'hématologie biologique, Pôle LaboratoiresNancyFrance
| | - Sylvain Salignac
- CHRU Nancy, Service d'hématologie biologique, Pôle LaboratoiresNancyFrance
| | - Julien Perrin
- INSERM, UMR_S 1116Vandœuvre‐lès‐NancyFrance,CHRU Nancy, Service d'hématologie biologique, Pôle LaboratoiresNancyFrance
| |
Collapse
|
12
|
Temporal variations in hematological, immunological and serum biochemical parameters of rainbow trout ( Oncorhynchus mykiss) acclimated to high-saline water in the Northern Aegean Sea. ANNALS OF ANIMAL SCIENCE 2022. [DOI: 10.2478/aoas-2022-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
The present study evaluated the health status of rainbow trout (30.24±5.34 g) acclimated to high-saline water (28‰). Among adaptation procedures, gradually-acclimated (for 48 h) fish showed best performance, which were then introduced to the offshore cage-farm for further monitoring of fish health in marine environment over a long-term period of 100 days, until harvest weight of 319.9±48.51 g. Fish health and welfare was evaluated by means of biochemical parameters (viscerasomatic index, hepatosomatic index, mesenteric fat index, and spleen somatic index), hematological parameters (serum glucose, triglyceride, cholesterol, total protein, albumin, globulin), and immune parameters (lysozyme, myeloperoxidase, respiratory burst and potential killing values). Gradual acclimation to high-saline water did not show any adverse effects on health parameters. No significant differences were found in biometric measures (P>0.05). However, a time-dependent increase was recorded in hematology markers (P<0.05) after seawater transfer, and the health status improved over long-term from March 7 to June 14, 2018. All serum biochemical markers, except the total protein showed significant alterations (P<0.05) in long-term but without detrimental influence by day-100. Therefore, it seems possible to expand trout farms from brackish water sites to higher saline environments up to 28‰ salinity, with no detrimental impacts on fish health, that in turns may significantly contribute to the extension of potential aquaculture sites to wider areas.
Collapse
|
13
|
Gulati G, Uppal G, Gong J. Unreliable Automated Complete Blood Count Results: Causes, Recognition, and Resolution. Ann Lab Med 2022; 42:515-530. [PMID: 35470271 PMCID: PMC9057813 DOI: 10.3343/alm.2022.42.5.515] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/05/2022] [Accepted: 04/05/2022] [Indexed: 12/03/2022] Open
Abstract
Automated hematology analyzers generate accurate complete blood counts (CBC) results on nearly all specimens. However, every laboratory encounters, at times, some specimens that yield no or inaccurate result(s) for one or more CBC parameters even when the analyzer is functioning properly and the manufacturer’s instructions are followed to the letter. Inaccurate results, which may adversely affect patient care, are clinically unreliable and require the attention of laboratory professionals. Laboratory professionals must recognize unreliable results, determine the possible cause(s), and be acquainted with the ways to obtain reliable results on such specimens. We present a concise overview of the known causes of unreliable automated CBC results, ways to recognize them, and means commonly utilized to obtain reliable results. Some examples of unreliable automated CBC results are also illustrated. Pertinent analyzer-specific information can be found in the manufacturers’ operating manuals.
Collapse
Affiliation(s)
- Gene Gulati
- Division of Hematopathology, Department of Pathology, Anatomy, and Cell Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Guldeep Uppal
- Division of Hematopathology, Department of Pathology, Anatomy, and Cell Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jerald Gong
- Division of Hematopathology, Department of Pathology, Anatomy, and Cell Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| |
Collapse
|
14
|
Kim SY, Kim HK. Obtaining Reliable CBC Results in Clinical Laboratories. Ann Lab Med 2022; 42:505-506. [PMID: 35470269 PMCID: PMC9057821 DOI: 10.3343/alm.2022.42.5.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hyun Kyung Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
15
|
Xu P, Fang K, Chen X, Liu Y, Dong Z, Zhu J, Lu K. The flagging features of the Sysmex XN-10 analyser for detecting platelet clumps and the impacts of platelet clumps on complete blood count parameters. Clin Chem Lab Med 2022; 60:748-755. [PMID: 35212492 DOI: 10.1515/cclm-2021-1226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/11/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Platelet clumps present in anticoagulant specimens may generate a falsely decreased platelet count and lead to an incorrect diagnosis. A clear understanding of the ability of a haematology analyser (HA) to detect platelet clumps is important for routine work in the clinical laboratory. METHODS Citrate-anticoagulated whole-blood samples were collected from various patients as a negative group. Adenosine diphosphate (ADP)-induced platelet aggregation was performed on those negative samples to mimic platelet-clump-containing (positive) samples. The 'platelet clumps' and 'platelet abnormal' flags generated by the Sysmex XN-10 instrument were used to assess the flagging performance of this HA and demonstrate its flagging features. The complete blood count (CBC) results of paired negative and positive samples were compared to evaluate the impact of platelet clumps on the CBC parameters. RESULTS A total of 187 samples were eligible for this study. The total accuracy, sensitivity, and specificity of the platelet clumps flag were 0.786, 0.626, and 0.947, respectively. The total accuracy, sensitivity, and specificity of the platelet abnormal flag were 0.631, 0.348, and 0.914, respectively. A separate assessment focusing on the positive samples with low platelet counts showed that the total sensitivities of the platelet clumps and platelet abnormal flags were 0.801 and 1.000, respectively. Platelet clumps may interfere with the leukocyte count and with platelet and erythrocyte indices. CONCLUSIONS Platelet clumps can influence not only platelet indices but also leukocyte and erythrocyte counts. The Sysmex XN-10 instrument is sensitive to positive samples with low platelet counts but insensitive to those with high platelet counts.
Collapse
Affiliation(s)
- Peng Xu
- Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, P.R. China
| | - Kui Fang
- Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, P.R. China
| | - Xiling Chen
- Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, P.R. China
| | - Yangruiqi Liu
- Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, P.R. China
| | - Zheqing Dong
- Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, P.R. China
| | - Ji Zhu
- Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, P.R. China
| | - Keda Lu
- Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, P.R. China
| |
Collapse
|
16
|
Layssol-Lamour CJ, Granat FA, Sahal AM, Braun JPD, Trumel C, Bourgès-Abella NH. Improving the Quality of EDTA-treated Blood Specimens from Mice. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2022; 61:188-194. [PMID: 35022109 PMCID: PMC8956217 DOI: 10.30802/aalas-jaalas-21-000093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 06/14/2023]
Abstract
Nonterminal blood sampling in laboratory mice is a very common procedure. With the goal of improving animal welfare, different sampling sites and methods have been compared but have not achieved a consensus. Moreover, most of these studies overlooked the quality of blood specimens collected. The main preanalytical concern with EDTA-treated blood specimens for hematology analyses is platelet aggregation, which is known to cause analytical errors. Our objective was to find a nonterminal blood sampling method with minimal adverse effects on mice and few or no platelet aggregates. We tested and compared 2 collection sites, 4 sampling methods, and 3 antithrombotic drugs in 80 C57BL6/j male and female mice by evaluating platelet aggregates on blood smears and platelet, WBC, and RBC counts. In addition, the blood collection process was carefully evaluated, and adverse effects were recorded. Platelet aggregation was lower in specimens collected from the jugular vein than from the facial vein, with no effect of the sampling device or the presence of an antithrombotic additive. Highly aggregated specimens were significantly associated with lower platelet counts, whereas aggregation had no effect on WBC or RBC counts. Adverse events during sampling were significantly associated with more numerous platelet aggregates. The jugular vein is thus a satisfactory sampling site in mice in terms of both animal welfare and low platelet aggregation. Using antithrombotic agents appears to be unnecessary, whereas improving sampling conditions remains a key requirement to ensure the quality of EDTA-treated blood specimens from mice.
Collapse
Affiliation(s)
- Catherine J Layssol-Lamour
- Centre Régional d’Exploration Fonctionnelle et de Ressources Expérimentales (CREFRE), Université de Toulouse, UMR 1037,INSERM, UPS, ENVT
| | - Fanny A Granat
- Centre de Recherches en Cancérologie de Toulouse, INSE=RM, Université de Toulouse; and
| | - Ambrine M Sahal
- Centre de Recherches en Cancérologie de Toulouse, INSE=RM, Université de Toulouse; and
| | | | - Catherine Trumel
- Centre Régional d’Exploration Fonctionnelle et de Ressources Expérimentales (CREFRE), Université de Toulouse, UMR 1037,INSERM, UPS, ENVT
| | - Nathalie H Bourgès-Abella
- Centre Régional d’Exploration Fonctionnelle et de Ressources Expérimentales (CREFRE), Université de Toulouse, UMR 1037,INSERM, UPS, ENVT
| |
Collapse
|
17
|
Habibabady ZA, Sendil S, Ellett F, Pollok F, Elias GF, French BM, Sun W, Braileanu G, Burdorf L, Irimia D, Pierson RN, Azimzadeh AM. Human erythrocyte fragmentation during ex-vivo pig organ perfusion. Xenotransplantation 2022; 29:e12729. [PMID: 35112383 PMCID: PMC8995366 DOI: 10.1111/xen.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/22/2021] [Accepted: 01/10/2022] [Indexed: 01/25/2023]
Abstract
Platelet sequestration is a common process during organ reperfusion after transplantation. However, instead of lower platelet counts, when using traditional hemocytometers and light microscopy, we observed physiologically implausible platelet counts in the course of ex-vivo lung and liver xenograft organ perfusion studies. We employed conventional flow cytometry (FC) and imaging FC (AMINS ImageStream X) to investigate the findings and found platelet-sized fragments in the circulation that are mainly derived from red blood cell membranes. We speculate that this erythrocyte fragmentation contributes to anemia during in-vivo organ xenotransplant.
Collapse
Affiliation(s)
- Zahra A. Habibabady
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD,Center for Transplantation Sciences and Department of Surgery, Massachusetts General Hospital and Harvard School of Medicine, Boston, MA
| | - Selin Sendil
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Felix Ellett
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard School of Medicine, and Shriners Burns Hospital, Boston, MA
| | - Franziska Pollok
- Center for Transplantation Sciences and Department of Surgery, Massachusetts General Hospital and Harvard School of Medicine, Boston, MA,Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriela F. Elias
- Center for Transplantation Sciences and Department of Surgery, Massachusetts General Hospital and Harvard School of Medicine, Boston, MA
| | - Beth M. French
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Wenji Sun
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Gheorghe Braileanu
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Lars Burdorf
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD,Center for Transplantation Sciences and Department of Surgery, Massachusetts General Hospital and Harvard School of Medicine, Boston, MA
| | - Daniel Irimia
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard School of Medicine, and Shriners Burns Hospital, Boston, MA
| | - Richard N. Pierson
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD,Center for Transplantation Sciences and Department of Surgery, Massachusetts General Hospital and Harvard School of Medicine, Boston, MA
| | - Agnes M. Azimzadeh
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD,Center for Transplantation Sciences and Department of Surgery, Massachusetts General Hospital and Harvard School of Medicine, Boston, MA
| |
Collapse
|
18
|
Biljak VR, Lapić I, Vidranski V, Herceg I, Tomić F, Šimac B, Horvat M, Čičak H, Vuljanić D, Dorotić A, Nikler A. Policies and practices in the field of laboratory hematology in Croatia - a current overview and call for improvement. Clin Chem Lab Med 2021; 60:271-282. [PMID: 34845883 DOI: 10.1515/cclm-2021-1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/18/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES In 2019 The Croatian Working Group for Laboratory Hematology, on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine, wanted to explore the background in field of laboratory hematology routine practice among Croatian laboratories in order to develop future strategies for producing national recommendations, if needed. METHODS During April and May 2019, a comprehensive survey covering all main parts of the total testing process within the field of laboratory hematology among Croatian medical laboratories was conducted. The survey comprised 49 inquiries. Data was collected using Survey Monkey (Palo Alto, CA, USA). All collected data was anonymized. RESULTS The response rate was 72%. There is still a substantial number of laboratories that have only three-part differential hematology analyzers (9%). Furthermore, a very high number of laboratories did not perform analyzer verification prior to implementation into routine work (31%). Out of those who have verified their analyzers, a diversity of guidelines and recommendations were used. Nearly 10% of the laboratories do not have a defined policy regarding specimen rejection. The majority of the participants perform internal quality control daily (83%), however, only 51% of respondents evaluate the agreement between different hematology analyzers on daily basis. Although more than 90% of Croatian laboratories have a defined policy regarding specimen rejection, only 61% of respondents continuously monitor quality indicators in routine practice. CONCLUSIONS The survey revealed substantial differences in all aspects of laboratory hematology practices among Croatian medical laboratories, indicating the need for universal recommendations at the national level.
Collapse
Affiliation(s)
- Vanja Radišić Biljak
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
| | - Ivana Lapić
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Valentina Vidranski
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ivona Herceg
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Medical Biochemistry Laboratory, General Hospital "Dr. Tomislav Bardek", Koprivnica, Croatia
| | - Franciska Tomić
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Clinical Chemistry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Brankica Šimac
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Martina Horvat
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia
| | - Helena Čičak
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
| | - Dora Vuljanić
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
| | - Adrijana Dorotić
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
| | - Ana Nikler
- Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia.,Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
| |
Collapse
|
19
|
Dave RG, Padiyar S, Mathew J, Nair SC. Unusual Morphological and Automated Hematology Analyzer Features in 3 Cases of B-cell Malignancy-associated Type I Cryoglobulinemic Vasculitis. Indian J Hematol Blood Transfus 2021; 37:658-663. [PMID: 34744348 DOI: 10.1007/s12288-021-01398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/10/2021] [Indexed: 10/22/2022] Open
Abstract
Type I cryoglobulins are monoclonal immunoglobulins produced due to underlying hematological malignancy. Cryoglobulins spontaneously precipitate from serum and plasma at low temperatures and become soluble again on rewarming to 37 °C. Processing of blood at temperature lower than 37 °C in the laboratory may cause precipitation of cryoglobulins resulting in interferences in the automated cell counter analysis. We report three patients with cryoglobulinemic vasculitis wherein each case had different morphology of cryoglobulin precipitates on peripheral blood film, like needle shaped bluish-gray crystals, amorphous weakly basophilic extracellular deposits extraneously indenting red blood cells and basophilic neutrophilic inclusions respectively. The effect of cryoglobulins on two technologically different automated cell counters based on principles of impedance, Volume-Conductivity-Scatter (VCS) and fluorescence flow cytometry was assessed. This case series provides interesting insight into the varying morphological features of cryoglobulins on May-Grunwald-Giemsa stained blood films and interference caused by cryoglobulins in different automated cell counter analysis resulting in pseudo-leucocytosis, pseudo-thrombocytosis, abnormal histograms and scatterplots. Identification of these hematologic abnormalities and artifacts induced by cryoglobulins is necessary since it may be the first clue leading to the timely diagnosis of cryoglobulinemia and hence the underlying hematological malignancy, as in our cases.
Collapse
Affiliation(s)
- Rutvi Gautam Dave
- Department of Transfusion Medicine and Immunohematology, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Shivraj Padiyar
- Department of Rheumatology, Christian Medical College, Vellore, India
| | - John Mathew
- Department of Rheumatology, Christian Medical College, Vellore, India
| | - Sukesh Chandran Nair
- Department of Transfusion Medicine and Immunohematology, Christian Medical College, Vellore, Tamil Nadu 632004 India
| |
Collapse
|
20
|
Idalan N, Zeitz JO, Weber CN, Müller E, Giger U. Comparative study of immunohematological tests with canine blood samples submitted for a direct antiglobulin (Coombs') test. Canine Med Genet 2021; 8:10. [PMID: 34645506 PMCID: PMC8515749 DOI: 10.1186/s40575-021-00107-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A 2019 ACVIM consensus statement on diagnostics for immune-mediated hemolytic anemia (IMHA) in dogs made testing recommendations. As data on the performance of immunohematological tests was lacking, we undertook a comparative analysis. MATERIAL AND METHODS Anticoagulated blood samples from 126 dogs suspected of having IMHA submitted to a diagnostic veterinary laboratory for a routine direct antiglobulin test (DAT) and from 28 healthy control dogs were evaluated for spherocytosis and autoagglutination before and after three saline washes. Samples were also subjected to different DATs: a gel minitube and an immunochromatographic strip kit used in clinics; neutral gel column cards, microtiter plates (at 4°, 22°, and 37°C), capillary tubes, and flow cytometry used in laboratories. RESULTS Samples from healthy dogs yielded negative results with all immunodiagnostic tests. Among the 126 samples submitted for DAT 67 were positive by a DAT utilizing microtiter plates with goat anti-dog antiglobulin DAT at 22°C. Notably, DAT results were comparable and consistent across all evaluated methods regardless of antiglobulin and temperature used. DAT+ dogs were more severely anemic and more likely to have erythroid regeneration compared to DAT- dogs. Macroscopic agglutination in tubes or on slides was observed in 48 samples after 1:1 and 1:4 blood to saline dilution, but only persisted in four samples after washing. Among the DAT+ samples, 57% had agglutination, 87% had spherocytosis, and 45% had both. There was good correlation between spherocytosis and DAT results from the six DAT techniques, but the correlation with autoagglutination was only fair. Clinical follow-up was available for 42 dogs. Of the sample from 12 DAT+ dogs collected during treatment, 10 remained DAT+ when tested 1-24 weeks after initial assessment. CONCLUSIONS Based upon this comparative prospective survey, all in-clinic and laboratory DAT techniques produced similar results when performed by trained personnel and can therefore be recommended for detection of antibody-coated erythrocytes and immunohematological diagnosis. In addition, use of these tests for monitoring response of IMHA dogs to treatment might be valuable.
Collapse
Affiliation(s)
- Nadine Idalan
- Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Johanna O Zeitz
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Corinna N Weber
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Elisabeth Müller
- Laboklin GmbH&Co.KG, Steubenstrasse 4, 97688, Bad Kissingen, Germany
| | - Urs Giger
- Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland.
- Section of Medical Genetics, University of Pennsylvania, 3900 Delancey St, Philadelphia, PA, 19104, USA.
| |
Collapse
|
21
|
Convenience of Hgb-O detected by optical method in XN-series hematology analyzers in evaluating hemoglobin concentration in samples with chylous turbidity. Sci Rep 2021; 11:14978. [PMID: 34294786 PMCID: PMC8298502 DOI: 10.1038/s41598-021-94394-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
The chylous turbidity of blood samples is one of the causes of false-high hemoglobin (Hgb) concentration measurements by the colorimetric method, which has been widely applied in hematology analyzers. In such cases, additional manual procedures are required to correct Hgb concentrations. We therefore examined the effectiveness of an optical method for measuring Hgb concentrations in samples with chylous turbidity using Hgb-O in the reticulocyte channel equipped in XN-series analyzers (Sysmex, Kobe, Japan). Hgb-O showed excellent basic performance, including linear correlation and invariability with sodium lauryl sulfate (SLS)-Hgb detected by the colorimetric method. In the analysis of samples from healthy volunteers supplemented with fat emulsion, chylous turbidity did not affect Hgb-O but SLS-Hgb, which was falsely increased according to the dose of fat emulsion. Actually, SLS-Hgb was falsely elevated in 34 of 40 chylous turbidity 3+ samples. The remaining 6 samples were measured in hematology analyzers where Hgb-O was inconsistent with SLS-Hgb in the internal quality control records. For these samples, the correction factors calculated from the internal quality control records could contribute to providing the corrected Hgb-O value. These findings suggested that the optical method was effective and convenient for accurately evaluating Hgb concentrations in samples with extremely chylous turbidity.
Collapse
|
22
|
Robier C, Hoefler G, Egger M. Simultaneous occurrence of EDTA-dependent lymphoagglutination and agglutination of myeloid cells in a patient with chronic myelomonocytic leukemia. Clin Chem Lab Med 2021; 59:e458-e460. [PMID: 34187102 DOI: 10.1515/cclm-2021-0616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/15/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Christoph Robier
- Institute of Laboratory Diagnostics, Hospital of the Brothers of St. John of God, Graz, Austria.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Gerald Hoefler
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
| |
Collapse
|
23
|
Grebert M, Granat F, Braun JP, Leroy Q, Bourgès-Abella N, Trumel C. Validation of the Sysmex XN-V hematology analyzer for canine specimens. Vet Clin Pathol 2021; 50:184-197. [PMID: 34152026 PMCID: PMC8362000 DOI: 10.1111/vcp.12936] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 01/14/2023]
Abstract
Background The Sysmex XN‐V is derived from the new Sysmex XN series of human hematology analyzers. The main changes from the previously validated XT‐2000iV analyzer include an optic‐fluorescent analysis for platelets and nucleated RBC count. Objective We aimed to validate the Sysmex XN‐V for canine blood according to American College for Veterinary Clinical Pathology and International Council for Standardization in Hematology recommendations. Materials and Methods Canine EDTA blood specimens and quality control material were analyzed on the Sysmex XN‐V to evaluate imprecision, bias, linearity, a comparison with the XT‐2000iV analyzer, interference effects, carry‐over, and stability. We also verified previously established Sysmex XT‐2000iV reference intervals (RIs). Results Imprecision and bias were low (<5%) for most variables. Observed total error was lower than allowable total error for most measured variables except lymphocytes and monocytes. Visually determined linearity was excellent for all variables, except for lymphocytes. The correlation between the XN‐V and XT‐2000iV analyzers was high (>0.93) for all variables except MCHC and reticulocyte indices. Correlations between the Sysmex XN‐V and manual differential counts were good for neutrophils and eosinophils, acceptable for lymphocytes, and fair for monocytes. Hemolysis, lipemia, and to a lesser extent icterus, had significant effects on measured hemoglobin concentration and associated variables. Carry‐over was not visually observed for any variable. Changes in the Sysmex XN‐V measurements after storage at 4℃ and 24℃ were similar to those described for the Sysmex XT‐2000iV analyzer. The previously established Sysmex XT‐2000iV RIs can be used to interpret results from the Sysmex XN‐V analyzer for most variables except red blood cell distribution width and mean platelet volume. Conclusions The performance of the Sysmex XN‐V analyzer was excellent and compared favorably with the Sysmex XT‐2000iV analyzer.
Collapse
Affiliation(s)
- Margot Grebert
- Département des Sciences Cliniques des animaux de compagnie et de sport, Université de Toulouse, ENVT, Toulouse, France.,CREFRE, Université de Toulouse, INSERM, ENVT, UPS, Toulouse, France
| | - Fanny Granat
- Département des Sciences Cliniques des animaux de compagnie et de sport, Université de Toulouse, ENVT, Toulouse, France.,CRCT, Université de Toulouse, INSERM, UMR 1037, Toulouse, France
| | | | - Quentin Leroy
- Département des Sciences Cliniques des animaux de compagnie et de sport, Université de Toulouse, ENVT, Toulouse, France
| | | | - Catherine Trumel
- Département des Sciences Cliniques des animaux de compagnie et de sport, Université de Toulouse, ENVT, Toulouse, France.,CREFRE, Université de Toulouse, INSERM, ENVT, UPS, Toulouse, France
| |
Collapse
|
24
|
Wang G, Zhao T, Fang Z, Lian H, Wang X, Li Z, Wu W, Li B, Zhang Q. Experimental evaluation of deep learning method in reticulocyte enumeration in peripheral blood. Int J Lab Hematol 2021; 43:597-601. [PMID: 34014615 DOI: 10.1111/ijlh.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/18/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Reticulocytes (RET) are immature red blood cells, and RET enumeration in peripheral blood has important clinical value in diagnosis, treatment efficacy observation, and prognosis of anemic diseases. For RET enumeration, flow cytometric reference method has shown to be more precise than the manual method by light microscopy. However, flow cytometric method generates occasionally spurious RET counts in some situations. The manual method, which is subjective, imprecise, and tedious, currently remains as an accepted reference method. As a result, there is a need for manual method to be more objective, precise, and rapid. METHODS 40 EDTA-K2 anticoagulated whole blood samples were randomly selected for the study. 784 microscopic images were taken from blood slides as dataset, and all mature RBCs and RETs in these images were located and labeled by experienced experts. Then, we leverage a Faster R-CNN deep neural network to train a RET detection model and evaluate the model. RESULTS Both the recall and precision rate of the model are more than 97%, and average analysis time of a single image is 0.21 seconds. CONCLUSION The deep learning method shows outstanding performance including high accuracy and fast speed. The experimental results show that the deep learning method holds the potential to act as a rapid computer-aid method for manual RET enumeration for cytological examiners.
Collapse
Affiliation(s)
- Geng Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China
| | - Tianci Zhao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China
| | - Zhejun Fang
- Beijing Xiaoying Technology Co., Ltd, Beijing, China
| | - Heqing Lian
- Beijing Xiaoying Technology Co., Ltd, Beijing, China
| | - Xin Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China
| | - Zepeng Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China
| | - Wei Wu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Beijing, China
| | - Bairui Li
- Beijing Xiaoying Technology Co., Ltd, Beijing, China
| | - Qian Zhang
- Beijing Xiaoying Technology Co., Ltd, Beijing, China
| |
Collapse
|
25
|
Pseudothrombocytopenia Inducing Nonindicated Platelet Transfusion after Cardiac Surgery. Case Rep Med 2021; 2021:3695407. [PMID: 33747091 PMCID: PMC7954639 DOI: 10.1155/2021/3695407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 11/18/2022] Open
Abstract
Pseudothrombocytopenia (PTCP) is an in vitro phenomenon of low platelet count caused by the agglutination of platelets, leading to false low platelet counts in automated cell counting. Typically, ethylenediaminetetraacetic acid (EDTA) mediates this platelet clumping. PTCP has little clinical significance, but misdiagnosis may lead to unnecessary diagnostic tests and treatment. In this case report, we present a 65-year-old Caucasian female suffering from multiple complications during and after cardiac surgery. During her postoperative stay at the ICU, she was diagnosed with thrombocytopenia and an inadequate response to platelet supplementation.
Collapse
|
26
|
Frater JL. How I investigate neutropenia. Int J Lab Hematol 2021; 42 Suppl 1:121-132. [PMID: 32543073 DOI: 10.1111/ijlh.13210] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 01/24/2023]
Abstract
Neutropenia is a common laboratory finding in adults and children. Its underlying causes are extremely heterogeneous and include benign conditions, autoimmune disorders, infections, and malignancies. The clinical laboratory plays a central role in the diagnosis of these disorders, including data derived from hematology, microbiology, molecular biology/cytogenetics, and clinical chemistry. The purpose of this review is to (a) highlight the clinical, hematologic, and molecular genetic features of the major entities resulting in neutropenia and (b) outline an algorithm-based approach to permit the classification of neutropenias.
Collapse
Affiliation(s)
- John L Frater
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
| |
Collapse
|
27
|
Johnson CE, Seelig DM, Moore FM, Ruska TJ, Heinrich DA. Spurious, marked leukocytosis in 2 cats with Heinz body hemolytic anemia. Vet Clin Pathol 2020; 49:232-239. [PMID: 32458505 DOI: 10.1111/vcp.12860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 12/01/2022]
Abstract
Two domestic shorthair cats were presented with anorexia and dehydration following ingestion of caramelized onions. Shared key findings from a CBC (ADVIA 2120), serum biochemistry, and urinalysis included a spurious, marked leukocytosis with discordant basophil (BASO) channel and peroxidase channel WBC counts, normal manual leukocyte counts, mild, non-regenerative anemia with discrepancies between automated and manual reticulocyte counts, an abundance of large Heinz bodies (HBs), and highly irregular scattergrams. Case 1 also demonstrated a markedly elevated mean corpuscular hemoglobin concentration (MCHC) and discrepancies between RBC hemoglobin indices. Spurious leukocyte results were confirmed through re-analysis of samples (including the acquisition of a new sample, use of an alternate analyzer (Sysmex XT-2000iV; Case 1 only), and evaluation of scattergrams and blood films (Cases 1 and 2). Repeatedly discrepant reticulocyte counts were also identified. In both cases, the erroneous BASO WBC counts, discrepancies in reticulocyte counts and RBC indices, and atypical scattergrams were interpreted to result from various effects of the HBs. These cases emphasize the importance of reviewing blood films, interpreting scattergrams, and the usefulness of duplicate methods for determining various measurands on hematology analyzers.
Collapse
Affiliation(s)
- Courtney E Johnson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Davis M Seelig
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | | | - Tammy J Ruska
- Veterinary Medical Center, University of Minnesota, St. Paul, MN, USA
| | - Daniel A Heinrich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| |
Collapse
|
28
|
Huisjes R, Makhro A, Llaudet-Planas E, Hertz L, Petkova-Kirova P, Verhagen LP, Pignatelli S, Rab MAE, Schiffelers RM, Seiler E, van Solinge WW, Corrons JLLV, Kaestner L, Mañú-Pereira M, Bogdanova A, van Wijk R. Density, heterogeneity and deformability of red cells as markers of clinical severity in hereditary spherocytosis. Haematologica 2020; 105:338-347. [PMID: 31147440 PMCID: PMC7012482 DOI: 10.3324/haematol.2018.188151] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/28/2019] [Indexed: 02/06/2023] Open
Abstract
Hereditary spherocytosis (HS) originates from defective anchoring of the cytoskeletal network to the transmembrane protein complexes of the red blood cell (RBC). Red cells in HS are characterized by membrane instability and reduced deformability and there is marked heterogeneity in disease severity among patients. To unravel this variability in disease severity, we analyzed blood samples from 21 HS patients with defects in ankyrin, band 3, α-spectrin or β-spectrin using red cell indices, eosin-5-maleimide binding, microscopy, the osmotic fragility test, Percoll density gradients, vesiculation and ektacytometry to assess cell membrane stability, cellular density and deformability. Reticulocyte counts, CD71 abundance, band 4.1 a:b ratio, and glycated hemoglobin were used as markers of RBC turnover. We observed that patients with moderate/severe spherocytosis have short-living erythrocytes of low density and abnormally high intercellular heterogeneity. These cells show a prominent decrease in membrane stability and deformability and, as a consequence, are quickly removed from the circulation by the spleen. In contrast, in mild spherocytosis less pronounced reduction in deformability results in prolonged RBC lifespan and, hence, cells are subject to progressive loss of membrane. RBC from patients with mild spherocytosis thus become denser before they are taken up by the spleen. Based on our findings, we conclude that RBC membrane loss, cellular heterogeneity and density are strong markers of clinical severity in spherocytosis.
Collapse
Affiliation(s)
- Rick Huisjes
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Asya Makhro
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Esther Llaudet-Planas
- Red Blood Cell Defects and Hematopoietic Disorders Unit, Josep Carreras Leukemia Research Institute, Badalona, Barcelona, Spain
| | - Laura Hertz
- Theoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg/Saar, Germany
| | - Polina Petkova-Kirova
- Theoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg/Saar, Germany
| | - Liesbeth P Verhagen
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Silvia Pignatelli
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Minke A E Rab
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Raymond M Schiffelers
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Elena Seiler
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Wouter W van Solinge
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Joan-LLuis Vives Corrons
- Red Blood Cell Defects and Hematopoietic Disorders Unit, Josep Carreras Leukemia Research Institute, Badalona, Barcelona, Spain
| | - Lars Kaestner
- Theoretical Medicine and Biosciences, Medical Faculty, Saarland University, Homburg/Saar, Germany.,Experimental Physics, Saarland University, Saarbruecken, Germany
| | - Maria Mañú-Pereira
- Rare Anemia Research Unit. Vall d'Hebron Research Institution, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Anna Bogdanova
- Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Richard van Wijk
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
29
|
Kawata E, Chin‐Yee I, Hsia C, Solh Z. IgA-mediated autoimmune hemolytic anemia. Am J Hematol 2020; 95:129-130. [PMID: 31328297 DOI: 10.1002/ajh.25581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/09/2019] [Accepted: 07/13/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Eri Kawata
- Division of Hematology, Department of MedicineLondon Health Sciences Centre London Ontario Canada
- Division of Hematology and OncologyKyoto Prefectural University of Medicine Kyoto Japan
| | - Ian Chin‐Yee
- Division of Hematology, Department of MedicineLondon Health Sciences Centre London Ontario Canada
- Transfusion Medicine Section, Department of Pathology & Laboratory Medicine, Schulich School of Medicine and DentistryWestern University London Ontario Canada
| | - Cyrus Hsia
- Division of Hematology, Department of MedicineLondon Health Sciences Centre London Ontario Canada
- Transfusion Medicine Section, Department of Pathology & Laboratory Medicine, Schulich School of Medicine and DentistryWestern University London Ontario Canada
| | - Ziad Solh
- Division of Hematology, Department of MedicineLondon Health Sciences Centre London Ontario Canada
- Transfusion Medicine Section, Department of Pathology & Laboratory Medicine, Schulich School of Medicine and DentistryWestern University London Ontario Canada
| |
Collapse
|
30
|
Piane L, Zémori C, Ribleau P, Guerlin M, Bourgès-Abella N, Trumel C. What is your diagnosis? Abnormal platelets dot plot from a dog. Vet Clin Pathol 2019; 48:481-483. [PMID: 31250456 DOI: 10.1111/vcp.12754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/25/2018] [Accepted: 09/02/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Laetitia Piane
- Departement des Sciences Cliniques des Animaux de Sport et de Loisir, Ecole Nationale Vétérinaire de Toulouse, Toulouse Cedex 3, France.,CREFRE, Université de Toulouse, INSERM-UPS-ENVT, Toulouse, France
| | - Cécile Zémori
- Departement des Sciences Cliniques des Animaux de Sport et de Loisir, Ecole Nationale Vétérinaire de Toulouse, Toulouse Cedex 3, France
| | - Pauline Ribleau
- Departement des Sciences Cliniques des Animaux de Sport et de Loisir, Ecole Nationale Vétérinaire de Toulouse, Toulouse Cedex 3, France
| | - Maud Guerlin
- Departement des Sciences Cliniques des Animaux de Sport et de Loisir, Ecole Nationale Vétérinaire de Toulouse, Toulouse Cedex 3, France
| | - Nathalie Bourgès-Abella
- CREFRE, Université de Toulouse, INSERM-UPS-ENVT, Toulouse, France.,Departement des Sciences Biologiques et Fonctionnelles, Ecole Nationale Vétérinaire de Toulouse, Toulouse Cedex 3, France
| | - Catherine Trumel
- Departement des Sciences Cliniques des Animaux de Sport et de Loisir, Ecole Nationale Vétérinaire de Toulouse, Toulouse Cedex 3, France.,CREFRE, Université de Toulouse, INSERM-UPS-ENVT, Toulouse, France
| |
Collapse
|
31
|
De la Salle B. Pre‐ and postanalytical errors in haematology. Int J Lab Hematol 2019; 41 Suppl 1:170-176. [DOI: 10.1111/ijlh.13007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/17/2019] [Accepted: 02/19/2019] [Indexed: 12/23/2022]
|
32
|
Garden OA, Kidd L, Mexas AM, Chang YM, Jeffery U, Blois SL, Fogle JE, MacNeill AL, Lubas G, Birkenheuer A, Buoncompagni S, Dandrieux JRS, Di Loria A, Fellman CL, Glanemann B, Goggs R, Granick JL, LeVine DN, Sharp CR, Smith-Carr S, Swann JW, Szladovits B. ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats. J Vet Intern Med 2019; 33:313-334. [PMID: 30806491 PMCID: PMC6430921 DOI: 10.1111/jvim.15441] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 01/18/2019] [Indexed: 12/21/2022] Open
Abstract
Immune-mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune-mediated erythrocyte destruction, and adverse consequences of long-term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence-based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.
Collapse
Affiliation(s)
- Oliver A Garden
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Linda Kidd
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California
| | - Angela M Mexas
- College of Veterinary Medicine, Midwestern University, Downers Grove, Illinois
| | - Yu-Mei Chang
- Royal Veterinary College, University of London, London, United Kingdom
| | - Unity Jeffery
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Shauna L Blois
- Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jonathan E Fogle
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Amy L MacNeill
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - George Lubas
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Adam Birkenheuer
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Simona Buoncompagni
- Internal Medicine Service, Central Oklahoma Veterinary Specialists, Oklahoma City, Oklahoma
| | - Julien R S Dandrieux
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, Australia
| | - Antonio Di Loria
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, Napoli, Italy
| | - Claire L Fellman
- Cummings School of Veterinary Medicine, Tufts University, Massachusetts
| | - Barbara Glanemann
- Royal Veterinary College, University of London, London, United Kingdom
| | - Robert Goggs
- College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Jennifer L Granick
- College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota
| | - Dana N LeVine
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Claire R Sharp
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
| | | | - James W Swann
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Balazs Szladovits
- Royal Veterinary College, University of London, London, United Kingdom
| |
Collapse
|
33
|
Rim JH, Chang MH, Oh J, Gee HY, Kim JH, Yoo J. Effects of Cold Agglutinin on the Accuracy of Complete Blood Count Results and Optimal Sample Pretreatment Protocols for Eliminating Such Effects. Ann Lab Med 2019; 38:371-374. [PMID: 29611389 PMCID: PMC5895868 DOI: 10.3343/alm.2018.38.4.371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/22/2017] [Accepted: 02/27/2018] [Indexed: 12/02/2022] Open
Affiliation(s)
- John Hoon Rim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Pharmacology, Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.,Department of Medicine, Physician-Scientist Program, Yonsei University Graduate School of Medicine, Seoul, Korea
| | - Myung Hee Chang
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Joowon Oh
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Heon Yung Gee
- Department of Pharmacology, Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.,Department of Medicine, Physician-Scientist Program, Yonsei University Graduate School of Medicine, Seoul, Korea
| | - Jeong Ho Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jongha Yoo
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
| |
Collapse
|
34
|
Kumar A, Goswami R, Masih M, Kakkar N. Spurious Leukocyte Counts and an Abnormal Histogram Pattern Due to Fibrin Clumps. Indian J Hematol Blood Transfus 2018; 34:785-787. [PMID: 30369770 DOI: 10.1007/s12288-018-0998-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Ashish Kumar
- 1Departments of Clinical Haematology, Hemato-oncology and Bone Marrow (Stem Cell) Transplantation, Christian Medical College and Hospital, Ludhiana, Punjab 141 008 India
| | - Ritesh Goswami
- 1Departments of Clinical Haematology, Hemato-oncology and Bone Marrow (Stem Cell) Transplantation, Christian Medical College and Hospital, Ludhiana, Punjab 141 008 India
| | - Markas Masih
- 1Departments of Clinical Haematology, Hemato-oncology and Bone Marrow (Stem Cell) Transplantation, Christian Medical College and Hospital, Ludhiana, Punjab 141 008 India
| | - Naveen Kakkar
- 2Departments of Pathology, Christian Medical College and Hospital, Brown Road, Ludhiana, Punjab 141 008 India
| |
Collapse
|
35
|
La Gioia A, Fumi M, Fiorini F, Pezzati P, Balboni F, Bombara M, Marini A, Pancione Y, Solarino L, Marchese E, Sale S, Rocco V, Fiorini M. Short preheating at 41°C leads to a red blood cells count comparable to that in RET channel of Sysmex analysers in samples showing cold agglutination. J Clin Pathol 2018. [PMID: 29535214 DOI: 10.1136/jclinpath-2017-204954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS The presence of cold agglutinin in blood samples can cause a spontaneous agglutination of red blood cells (RBCs) when low temperature occurs. This phenomenon causes a spurious lowering of RBC count on the automated haematological analysers that are detected by incongruous values (≥370 g/L) of the mean cellular haemoglobi concentration (MCHC). A preheating at 37°C can remove the RBC agglutination generally resulting in a reliable count. It has been reported that the same result can be reached by using the optical reticulocyte (RET) channel of Sysmex analysers where the RBC count is not influenced by the presence of cold agglutinin. This study aims to evaluate these data in a larger population, with regard to environmental conditions on Sysmex analysers. We have also evaluated the influence of different thermal pretreatments on the RBC count. METHODS This study was performed on 96 remnants of peripheral blood samples (48 with MCHC in normal range and 48 with MCHC>370 g/L) which have been analysed in different preanalytical conditions on the Sysmex analysers. RESULTS A preheating of samples at 41°C for 1 min leads to a reversibility of the cold agglutination comparable to the one observed in the RET channel and yields better results compared with 37°C for 2 hours. CONCLUSIONS None of described procedures assure the complete cold agglutination reversibility in every case. Consequently, since the haematological analysers not yet provide reliable parameters to confirm the complete resolution of agglutination, further verification of RBC count accuracy needs to be performed.
Collapse
Affiliation(s)
- Antonio La Gioia
- Docemus Onlus "Theoretical and Practical Training School for Improving Specialty Medicine", Torrevecchia Teatina, Italy
| | - Maurizio Fumi
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Fabiana Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Pontedera, Italy
| | - Paola Pezzati
- Centro Regionale Controllo di Qualità AOU Careggi, Firenze, Italy
| | - Fiamma Balboni
- Laboratorio Analisi IFCA (Istituto Fiorentino di Cura ed Assistenza), Firenze, Italy
| | - Maria Bombara
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Livorno, Italy
| | - Alessandra Marini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Versilia, Italy
| | | | - Leonardo Solarino
- UOC Laboratorio Analisi I - Policlinico Vittorio Emanuele, Azienda Universitaria Ospedaliera, Catania, Italy
| | - Elisa Marchese
- UOC Laboratorio Analisi I - Policlinico Vittorio Emanuele, Azienda Universitaria Ospedaliera, Catania, Italy
| | - Silvia Sale
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Vincenzo Rocco
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Marcello Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Livorno, Italy
| |
Collapse
|
36
|
Pether NS, Brothwood JL, van Berkel C, Dunwoodie EH, Blake RL, Price CP, Jones RG, Baker KS, Hall G. Comparative Diagnostic Performance of the Granulocyte and Neutrophil Counts. Pract Lab Med 2017; 9:45-52. [PMID: 29159255 PMCID: PMC5683674 DOI: 10.1016/j.plabm.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/13/2017] [Accepted: 10/02/2017] [Indexed: 12/29/2022] Open
Abstract
Objectives Use of point-of-care testing is increasing, however many haematology analysers can only determine granulocyte count without further differentiation into neutrophils, eosinophils and basophils. Since the diagnosis of life-threatening neutropenia in cancer patients requires a distinct neutrophil count, this study aimed to determine the comparative performance between the neutrophil and granulocyte count. Design and methods A database of 508 646 venous full blood count results measured on a laboratory reference analyser was mined from a large oncology unit. The relationship between granulocyte and neutrophil counts was assessed. Multinomial logistic regression was used to classify results into neutropenia grades using an equivalent granulocyte count. Results Granulocyte to neutrophil count correlation was 0.997. The accuracy for classification into neutropenia grades using the derived equivalent granulocyte count ranges was 96.4%. Identification of results with a neutrophil count <1.5×109 cells/L using an equivalent granulocyte count of <1.69×109 cells/L resulted in sensitivity, specificity, positive and negative predictive values of 98.0%, 99.5%, 97.8% and 99.5%, respectively. Conclusions These results describe the relationship between granulocyte and neutrophil counts, measured on a laboratory analyser, in a large population of patients with malignancies and receiving anti-cancer therapies. However, this relationship must be established using a point of care testing system with a three-part differential count before considering the possibility that a granulocyte count can guide clinical decisions in the absence of a definitive neutrophil count, to reduce the frequency and severity of neutropenic complications in patients receiving cancer treatments.
Collapse
Affiliation(s)
- Nicola S Pether
- Institute of Health Science, the University of Leeds, UK.,Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Philips Electronics UK Ltd., UK
| | - Jessica L Brothwood
- Institute of Health Science, the University of Leeds, UK.,Philips Electronics UK Ltd., UK
| | - Cornelis van Berkel
- Institute of Health Science, the University of Leeds, UK.,Philips Electronics UK Ltd., UK
| | - Elaine H Dunwoodie
- Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Leeds Institute of Cancer and Pathology, University of Leeds, UK
| | - Robert L Blake
- Institute of Health Science, the University of Leeds, UK.,Philips Electronics UK Ltd., UK
| | - Christopher P Price
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Richard G Jones
- Institute of Health Science, the University of Leeds, UK.,Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Karl S Baker
- Institute of Health Science, the University of Leeds, UK.,Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Geoff Hall
- Institute of Health Science, the University of Leeds, UK.,Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Leeds Institute of Cancer and Pathology, University of Leeds, UK
| |
Collapse
|
37
|
Wu DW, Li YM, Wang F. How Long can we Store Blood Samples: A Systematic Review and Meta-Analysis. EBioMedicine 2017; 24:277-285. [PMID: 28965875 PMCID: PMC5652294 DOI: 10.1016/j.ebiom.2017.09.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/11/2017] [Accepted: 09/18/2017] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To assess the effect of storage time and temperature on complete blood count (CBC) and comprehensive metabolic panel (CMP) testing. METHODS PubMed, EMBASE, the Cochrane Library of Systematic Reviews, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), WanFang databases and SinoMed databases were searched up to May 2017. Clinical trials with adult whole blood samples were identified. Paired reviewers independently screened, extracted data and evaluated the quality of evidence (MINORS tool). Analyses were conducted using Revman 5.3 and Stata 14.0. RESULTS A total of 89 studies were confirmed. For CBC, except MPV, most parameters were stable at least for 24h. Some indices, such as WBC, PLt, HCT, HGB and MCH were stable up to 3 d. However, stable CMP test results could only be acquired within 12h. at 4°C, including GLU, AST, ALT, Na, ALB, Cl, DBIL, TC, TG and ALP. Values were less stable when stored at RT. CONCLUSIONS Specimens stored >12h. for CMP may generate unreliable results. For CBC, samples could reliably be stored for 24h. For longer storage, refrigeration (at 4°C) would be a better choice.
Collapse
Affiliation(s)
- Dong-Wen Wu
- Third Xiangya Hospital, Central South University, Changsha, China.
| | - Yu-Meng Li
- Third Xiangya Hospital, Central South University, Changsha, China
| | - Fen Wang
- Third Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
38
|
Dannhauser D, Rossi D, Memmolo P, Causa F, Finizio A, Ferraro P, Netti PA. Label-free analysis of mononuclear human blood cells in microfluidic flow by coherent imaging tools. JOURNAL OF BIOPHOTONICS 2017; 10:683-689. [PMID: 27503536 DOI: 10.1002/jbio.201600070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/31/2016] [Accepted: 07/11/2016] [Indexed: 05/24/2023]
Abstract
The investigation of the physical properties of peripheral blood mononuclear cells (PBMC) is of great relevance, as they play a key role in regulating human body health. Here we report the possibility to characterize human PBMC in their physiological conditions in a microfluidic-based measurement system. A viscoelastic polymer solution is adopted for 3D alignment of individual cells inflow. An optical signature (OS) acquisition of each flowing cell is performed using a wide angle light scattering apparatus. Besides, a quantitative phase imaging (QPI) holographic system is employed with the aim (i) to check the position in flow of individual cells using a holographic 3D cell tracking method; and (ii) to estimate their 3D morphometric features, such as their refractive index (RI). Results obtained by combining OS and QPI have been compared with literature values, showing good agreement. The results confirm the possibility to obtain sub-micrometric details of physical cell properties in microfluidic flow, avoiding chemical staining or fluorescent labelling.
Collapse
Affiliation(s)
- David Dannhauser
- Center for Advanced Biomaterials for Healthcare@CRIB, Istituto Italiano di Tecnologia (IIT), Largo Barsanti e Matteucci 53, 80125, Naples, Italy
| | - Domenico Rossi
- Center for Advanced Biomaterials for Healthcare@CRIB, Istituto Italiano di Tecnologia (IIT), Largo Barsanti e Matteucci 53, 80125, Naples, Italy
| | - Pasquale Memmolo
- CNR-ISASI Institute of Applied Sciences & Intelligent Systems "E. Caianiello", Via Campi Flegrei 34, 80078, Pozzuoli, Italy
| | - Filippo Causa
- Interdisciplinary Research Centre on Biomaterials (CRIB), Università degli Studi di Napoli "Federico II", Piazzale Tecchio 80, 80125, Naples, Italy
- Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale (DICMAPI), Università degli Studi di Napoli "Federico II", Piazzale Tecchio 80, 80125, Naples, Italy
| | - Andrea Finizio
- CNR-ISASI Institute of Applied Sciences & Intelligent Systems "E. Caianiello", Via Campi Flegrei 34, 80078, Pozzuoli, Italy
| | - Pietro Ferraro
- CNR-ISASI Institute of Applied Sciences & Intelligent Systems "E. Caianiello", Via Campi Flegrei 34, 80078, Pozzuoli, Italy
| | - Paolo A Netti
- Center for Advanced Biomaterials for Healthcare@CRIB, Istituto Italiano di Tecnologia (IIT), Largo Barsanti e Matteucci 53, 80125, Naples, Italy
- Interdisciplinary Research Centre on Biomaterials (CRIB), Università degli Studi di Napoli "Federico II", Piazzale Tecchio 80, 80125, Naples, Italy
- Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale (DICMAPI), Università degli Studi di Napoli "Federico II", Piazzale Tecchio 80, 80125, Naples, Italy
| |
Collapse
|
39
|
Raleigh JS, Jandrey KE, Burges J, Kent MS. Factors Affecting Platelet Concentration in Platelet Concentrates from Canine Blood Donors. J Vet Intern Med 2017; 31:759-763. [PMID: 28421625 PMCID: PMC5435050 DOI: 10.1111/jvim.14719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/10/2017] [Accepted: 03/23/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Physiologic factors in dogs that might contribute to enhanced platelet yield in platelet concentrates (PCs) are largely unknown. OBJECTIVE To determine whether individual differences in weight, age, preprocessing blood chemistry, and CBC variables predict the final platelet concentrations in PCs. Our hypotheses were (1) increased lipemic indices would be positively associated with increased platelet concentrations in PCs and (2) increased preprocessing platelet concentrations would be associated with higher platelet concentrations in the PCs. ANIMALS All blood donation records of dogs from February 2, 2009 through April 1, 2015 at the University of California-Davis Veterinary Blood Bank were examined with 104 cases included in this study. METHODS In this retrospective study, data were collected from medical records of canine blood donors. Records were reviewed for internal consistency and accuracy and subjects were included in the study if donor screening and donation occurred on the same day and a viable PC was obtained. Univariate and multivariable regressions were used to test the impact that each variable had on the final platelet concentration in PCs. RESULTS Final platelet concentration in PCs was positively associated with the predonation CBC platelet values (P < .001), lipemic index (P = .01), and phosphorous levels (P = .001). Collectively these 3 variables explained 29% of the variance in platelet concentrations in PCs. CONCLUSIONS AND CLINICAL IMPORTANCE Future prospective studies are required to determine if canine blood donations from dogs with lipemia yield PCs with higher platelet concentrations without negatively affecting other blood components.
Collapse
Affiliation(s)
- J S Raleigh
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis School of Veterinary Medicine, Davis, CA
| | - K E Jandrey
- Department of Surgical and Radiological Sciences, University of California Davis School of Veterinary Medicine, Davis, CA
| | - J Burges
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis School of Veterinary Medicine, Davis, CA
| | - M S Kent
- Department of Surgical and Radiological Sciences, University of California Davis School of Veterinary Medicine, Davis, CA
| |
Collapse
|
40
|
Changes of hematological references depends on storage period and temperature conditions in rats and dogs. Lab Anim Res 2016; 32:241-248. [PMID: 28053618 PMCID: PMC5206231 DOI: 10.5625/lar.2016.32.4.241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/05/2016] [Accepted: 12/06/2016] [Indexed: 11/21/2022] Open
Abstract
Because changes in rat and dog hematological parameters according to storage conditions have been poorly documented, we sought to examine such changes. Blood analysis was performed using two hematology analyzers (ADVIA 2120i and Sysmex XN-V) after storage at room temperature and in cold storage for 5, 24, and 48 h, respectively. Interassay coefficients of variation for hematological parameters analyzed with the ADVIA 2120i and the XN-V showed similar. The levels of hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelet (PLT) showed significant variations with time in blood samples of rats and dogs. The leukocyte subpopulation showed high variation with storage conditions. The data for leukocyte differential counts obtained using the ADVIA 2120i, XN-V, and a manual differential counting procedure showed good agreement for neutrophils and lymphocyte counts, but monocytes, eosinophils, and basophils showed differences between the procedures. In conclusions, most rat and dog hematological parameters showed minimal changes; however, some showed high variation with storage time and temperature, especially PLT and leukocyte subpopulations. In conclusion, when performing hematological analysis in dogs and rats, it will be exactitude to analyze blood samples in fresh condition and at least within 24 h in the cold storage.
Collapse
|
41
|
Onishi S, Ichiba T, Miyoshi N, Nagata T, Naito H. Unusual underlying disorder for pulmonary embolism: Cold agglutinin disease. J Cardiol Cases 2016; 15:43-45. [PMID: 30546693 DOI: 10.1016/j.jccase.2016.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/13/2016] [Accepted: 10/06/2016] [Indexed: 11/24/2022] Open
Abstract
Cold agglutinin disease (CAD) is a form of autoimmune hemolytic anemia caused by cold-reacting autoantibodies. The manifestations of CAD are commonly anemia, acrocyanosis, and fatigue caused by hemolysis and agglutination of red blood cells (RBCs) at a temperature lower than normal body temperature. We report a case of CAD presenting with pulmonary embolisms in an 86-year-old man. The patient visited our emergency department complaining of acute chest pain and respiratory distress. Laboratory data showed decreased RBC and hematocrit and markedly elevated mean corpuscular hemoglobin (MCH) and MCH concentration (MCHC). A contrast-enhanced computed tomographic scan demonstrated bilateral massive pulmonary embolisms. After admission, diagnosis of CAD was made on the basis of a high cold agglutinin titer without other factors of coagulation. CAD can contribute to the onset of pulmonary embolisms. It is necessary to incubate blood samples at 37 °C when laboratory data show markedly elevated MCH and MCHC and to consider the presence of cold agglutinins as an underlying disorder for the formation of venous thrombosis. <Learning objective: Cold agglutinin disease can contribute to the onset of pulmonary embolisms. It is necessary to incubate blood samples at 37 °C when laboratory data showed markedly elevated mean corpuscular hemoglobin (MCH) and MCH concentration (MCHC) and to consider the presence of cold agglutinins as an underlying disorder for the formation of venous thrombosis. Complete blood count including MCH and MCHC is always ordered, but we may have overlooked the meaning of abnormal results. We must be aware of these parameters and carefully examine the underlying mechanisms of thrombosis.>.
Collapse
Affiliation(s)
- Shumpei Onishi
- Department of Emergency Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Toshihisa Ichiba
- Department of Emergency Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Natsuki Miyoshi
- Department of Clinical Laboratory, Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Takeshi Nagata
- Department of Emergency Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Hiroshi Naito
- Department of Emergency Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan
| |
Collapse
|
42
|
Joshi A, McVicker W, Segalla R, Favaloro E, Luu V, Vanniasinkam T. Determining the stability of complete blood count parameters in stored blood samples using the SYSMEX XE-5000 automated haematology analyser. Int J Lab Hematol 2015; 37:705-14. [DOI: 10.1111/ijlh.12389] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 04/27/2015] [Indexed: 11/27/2022]
Affiliation(s)
- A. Joshi
- Institute of Clinical Pathology and Medical Research; Westmead Hospital; Sydney NSW Australia
| | - W. McVicker
- Institute of Clinical Pathology and Medical Research; Westmead Hospital; Sydney NSW Australia
| | - R. Segalla
- Institute of Clinical Pathology and Medical Research; Westmead Hospital; Sydney NSW Australia
| | - E. Favaloro
- Institute of Clinical Pathology and Medical Research; Westmead Hospital; Sydney NSW Australia
| | - V. Luu
- Institute of Clinical Pathology and Medical Research; Westmead Hospital; Sydney NSW Australia
| | | |
Collapse
|
43
|
Evaluation of nucleated red blood cell count by Sysmex XE-2100 in patients with thalassaemia or sickle cell anaemia and in neonates. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 13:588-94. [PMID: 25761322 DOI: 10.2450/2015.0283-14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/16/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Current haematology analysers have variable sensitivity and accuracy for counting nucleated red blood cells in samples with low values and in all those conditions characterised by altered sensitivity of red blood cells to the lysing process, such as in beta-thalassaemia or sickle-cell diseases and in neonates. The aim of our study was to evaluate the performance of the automated analyser XE-2100 at counting nucleated red blood cells in the above-mentioned three categories of subjects with potentially altered red blood cell lysis sensitivity and yet a need for accurate nucleated red blood cell counts. MATERIALS AND METHODS We measured nucleated red blood cell count by XE-2100 in peripheral blood samples of 187 subjects comprising 55 patients with beta-thalassaemia (40 major and 15 traits), 26 sickle-cell patients, 56 neonates and 50 normal subject. Results were compared with those obtained by optical microscopy. Agreement between average values of the two methods was estimated by means of Pearson's correlation and bias analysis, whereas diagnostic accuracy was estimated by analysis of receiver operating characteristic curves. RESULTS The comparison between the two methods showed a Pearson's correlation of 0.99 (95% CI; 0.98-0.99; p<0.001) and bias of -0.61 (95% CI, -1.5-0.3). The area under the curve of the nucleated red blood cell count in all samples was 0.98 (95% CI, 0.96-1.00; p<0.001). Sub-analysis revealed an area under curve of 0.99 (95% CI, 0.98-1.00; p<0.001) for patients with thalassaemia, 0.94 (95% CI, 0.85-1.00; p<0.001) for patients with sickle cell anaemia, and 1.00 (95% CI, 1.0-1.0) for neonates. DISCUSSION XE-2100 has excellent performance for nucleated red blood cell counting, especially in critical populations such as patients with haemoglobinopathies and neonates.
Collapse
|
44
|
|
45
|
|
46
|
|
47
|
Vercruysse D, Dusa A, Stahl R, Vanmeerbeeck G, de Wijs K, Liu C, Prodanov D, Peumans P, Lagae L. Three-part differential of unlabeled leukocytes with a compact lens-free imaging flow cytometer. LAB ON A CHIP 2015; 15:1123-32. [PMID: 25537881 DOI: 10.1039/c4lc01131g] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
A compelling clinical need exists for inexpensive, portable haematology analyzers that can be utilized at the point-of-care in emergency settings or in resource-limited settings. Development of a label-free, microfluidic blood analysis platform is the first step towards such a miniaturized, cost-effective system. Here we assemble a compact lens-free in-line holographic microscope and employ it to image blood cells flowing in a microfluidic chip, using a high-speed camera and stroboscopic illumination. Numerical reconstruction of the captured holograms allows classification of unlabeled leukocytes into three main subtypes: lymphocytes, monocytes and granulocytes. A scale-space recognition analysis to evaluate cellular size and internal complexity is also developed and used to build a 3-part leukocyte differential. The lens-free image-based classification is compared to the 3-part white blood cell differential generated by using a conventional analyzer on the same blood sample and is found to be in good agreement with it.
Collapse
|
48
|
Verbrugge SE, Huisman A. Verification and standardization of blood cell counters for routine clinical laboratory tests. Clin Lab Med 2014; 35:183-96. [PMID: 25676379 DOI: 10.1016/j.cll.2014.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The use of automated blood cell counters (automated hematology analyzers) for diagnostic purposes is inextricably linked to clinical laboratories. However, the need for uniformity among the various methods and parameters is increasing and standardization of the automated analyzers is therefore crucial. Standardization not only involves procedures based on reference methods but it also involves validation, verification, quality assurance, and quality control, and it includes the involvement of several participants. This article discusses the expert guidelines and provides an overview of issues involved in complete blood count parameter reference methods and standardization of reporting units.
Collapse
Affiliation(s)
- Sue Ellen Verbrugge
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, PO Box: 85500, Utrecht 3508 GA, The Netherlands
| | - Albert Huisman
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, PO Box: 85500, Utrecht 3508 GA, The Netherlands.
| |
Collapse
|
49
|
Ercan S, Calışkan M, Koptur E. 70-year old female patient with mismatch between hematocrit and hemoglobin values: the effects of cold agglutinin on complete blood count. Biochem Med (Zagreb) 2014; 24:391-5. [PMID: 25351358 PMCID: PMC4210260 DOI: 10.11613/bm.2014.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 06/29/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction: There are a number of pre-analytical and analytical factors, which cause false results in the complete blood count. The present case identifies cold agglutinins as the cause for the mismatch between hematocrit and hemoglobin values. Materials and methods: 70-year old female patient had a history of cerebrovascular diseases and rheumatoid arthritis. During routine laboratory examination, the patient had normal leukocyte and platelet counts; however, the hemoglobin (Hb: 105 g/L) and hematocrit (HCT: 0.214 L/L) results were discordant. Hemolysis, lipemia and cold agglutinin were evaluated as possible reasons for the mismatch between hematocrit and hemoglobin values. Results: First blood sample was slightly hemolysed. Redrawn sample without hemolysis or lipemia was analyzed but the mismatch became even more distinct (Hb: 104 g/L and HCT: 0.08 L/L). In this sample, the titration of the cold agglutinin was determined and found to be positive at 1:64 dilution ratios. After an incubation of the sample at 37°C for 2 hours, reversibility of agglutination was observed. Conclusion: We conclude that cold agglutinins may interfere with the analysis of erythrocyte and erythrocyte-related parameters (HCT, MCV, MCH and MCHC); however, Hb, leukocyte and platelet counts are not affected.
Collapse
Affiliation(s)
- Serif Ercan
- Department of Clinical Biochemistry, Lüleburgaz State Hospital, Kırklareli, Turkey
| | - Mustafa Calışkan
- Departments of Clinical Microbiology, Lüleburgaz State Hospital, Kırklareli, Turkey
| | - Erhan Koptur
- Home Health Services, Lüleburgaz State Hospital, Kırklareli, Turkey
| |
Collapse
|
50
|
Xiao Y, Xu Y. Concomitant spuriously elevated white blood cell count, a previously underestimated phenomenon in EDTA-dependent pseudothrombocytopenia. Platelets 2014; 26:627-31. [PMID: 25275874 DOI: 10.3109/09537104.2014.963543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The proportion and potential risk of concomitant spuriously elevated white blood cell count (SEWC) are underestimated in ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia (PTCP). The proportion, kinetics and prevention of SEWC remain poorly understood. A total of 25 patients with EDTA-dependent PTCP were enrolled in this study. With the hematology analyzer Coulter LH 750, we determined the time courses of WBC count, WBC differential and platelet count in EDTA- and sodium citrate-anticoagulated blood, respectively. Blood smears were prepared to inspect the presence of platelet clumps using light microscopy. The effect of automatic instrumental correction on the extent of SEWC was evaluated. The proportion of SEWC was 92% in EDTA-dependent PTCP and 73.9% of SEWCs were within the normal range. The development of SEWC was time-dependent, and neutrophils and lymphocytes were the main subpopulations involved in SEWC. A strong and significant correlation (r = 0.9937, p < 0.001) was found between the increased WBC count and the decreased platelet count. Both corrected and uncorrected WBC counts at 15 minutes or later after blood collection in EDTA were significantly higher than their basal counts, respectively, p < 0.05. Interestingly, in citrated blood, WBC counts after blood collection were not significantly different from its basal counts, p > 0.05. A high proportion of concomitant SEWCs, which are mainly within normal range, are present in patients with EDTA-dependent PTCP. Proper interpretation of SEWC is crucial to avoid clinic errors. SEWC develops in a time-dependent pattern, although the Coulter LH 750 only partly mitigates the extent of SEWC, sodium citrate is able to effectively prevent SEWC.
Collapse
Affiliation(s)
- Yufei Xiao
- a Department of Laboratory Medicine , the Second Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China and
| | | |
Collapse
|