Age‐ and sex‐specific reference intervals for hematologic analytes in Chinese children

Abstract

Reference intervals are very important for clinical laboratory diagnosis and physiological evaluation. 1 The accuracy and applicability of such reference intervals directly affect the efficient diagnosis and treatment of the disease. Hematology is commonly used to assess health and disease states associated with blood disorders, infectious diseases, and the immune system. 2 However, suitable age-and sexspecific reference intervals of hematologic analytes of children are often lacking or incomplete. Children are not small adults, and consensus guidelines for adults may not apply to children. 3 Hematological reference intervals are affected by many factors such as the location of the population, economic background, lifestyle habits, and dietary structure. While it is inappropriate to randomly use the reference intervals established in other countries, there are no standard pediatric reference intervals for China. Therefore, it is necessary to establish a hematological reference range for Chinese children. The purpose of this study was to establish the age-and Abstract Introduction: Reference intervals for pediatric laboratory tests need to be interpreted in the context of age-and sex-dependent dynamics. However, few reference intervals for healthy ethnic Han Chinese children have previously attempted to establish using large sample sizes. As such, there are no national hematological standards in China for pediatric reference intervals. Methods:We used a direct method to enroll a total of 2164 healthy 1-to 7-year-old children from Henan province. Hematological reference intervals were established by analyzing venous blood sample data on 17 hematologic analytes. The reference values for different ages and sexes were estimated using both parametric methods (mean ± 2 SD) and nonparametric methods (2.5-97.5th percentiles). Results:We provided reference intervals for 17 hematologic analytes including red blood count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width, white blood count and differential count as well as platelet count and related parameters. Conclusion:We established age-and sex-specific reference intervals that can provide more evidence-based guidance for the diagnosis and treatment for pediatric diseases. Our findings provide the basis for the next step in establishing national blood testing standards. K E Y W O R D Schildren, hematologic analytes, reference interval, venous blood

Correlations between inflammatory response and the increased lymphocyte percentage or CD19+ cell count in Kawasaki disease children undergoing intravenous immunoglobulin in different age intervals

“…In all different age groups, during the acute phase of KD all patients' neutrophil percentage increased abnormal highly compared to that of the value in the healthy children newly published. Inversely all KD children's lymphocyte percentage of was obviously lower than the value in the healthy children 6 [12]. After the treatment of IVIg, all patients' neutrophil percentage decreased and lymphocyte percentage increased obviously as shown in Table 2.…”

“…In the same way, we got the increase percentage of lymphocyte using the data before and after IVIg. All data compared with the normal value established in different age intervals from newly published reference [12]. Following that, linear-regression analysis was performed between the two scopes in different age groups.…”

Correlations between inflammatory response and lymphocyte percentage or CD19+ B cell count in Kawasaki disease children at different ages undergoing intravenous immunoglobulin: a retrospective study

“…The paired t test also used to compare the corresponding normal values published in the literature with the mean, upper and lower limits of the neutrophil percentage before the IVIG treatment in children of different ages [4]. The same method was used to study lymphocyte percentage in every group.…”

“…Expression level of inflammatory factors were also recorded including tumor necrosis factor (TNF), interleukin 1 (IL-1), IL-2 receptor and IL-6 at 1 day before and 3 days after IVIG. [4,5]. In our study, children with KD were at this age interval a phase full of development and maturity.…”

“…Studies have shown that the lymphocyte percentage gradually declines and neutrophil percent increases year by year as children grow. During growth and development, medians, upper limit and low limit of different hematologic cells change [4,5]. Therefore, it is understandable the inflammatory response differ in KD children in diverse age groups.…”