Introduction: Red blood cell (RBC) indices and histogram obtained from automated analyzer give an idea about morphological changes in anaemia. Along with the peripheral smear, they can be used to interpret the cause of anaemia. The aim of the present study was to correlate typing of anaemia based on RBC indices and histograms obtained from automated analyzer with peripheral smear examination and to give a better approach in the diagnosis of anaemia and analyse their limitations. Material and methods: Blood samples collected from 1575 anaemic patients, over a period of one year, in the Hematology laboratory, were typed for anaemia, first by parameters obtained by haematology analyzer (RBC indices with red cell distribution width) and then by peripheral blood smear findings. The correlation between the diagnosis made by peripheral smear versus RBC indices and histogram were analysed to find out the significance of the mean difference in various parameters. Results: Microcytic hypochromic anaemia (50.86%) was the most common followed by normocytic normochromic (25.14%), macrocytic (2.29%), dimorphic (15.43%) and haemolytic anaemia (6.29%) as diagnosed on peripheral smear examination. Analysis by RBC indices showed 59.43%, 32%, 3.43%, 2.86% and 2.29% of microcytic hypochromic, normocytic normochromic, macrocytic, dimorphic and haemolytic anaemia respectively. Out of 801 (50.86%) cases of microcytic hypochromic anaemia on smear, 513(32.5%) revealed left shift while 288 (18.3%) showed broad-based curve on the histogram. In normocytic normochromic anaemia, anormal bell-shaped curve was seen in 378 cases (25%) while 18 cases (1.1%) showed the broad curve. Histograms in macrocytic anaemia show a right shift in 27 cases (1.7%) while 9 cases (0.6%) showed left shift. In dimorphic anaemia, the histogram was bimodal only in 2.9% of cases whereas a majority (11.4%) showed broad-base histogram. Conclusion: Histogram and RBC indices give valuable information, but peripheral smear examination remains the important diagnostic tool in haematological disorders.
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