Can peripheral blood smear examination be totally replaced by automated hematology analyser - with special reference to anemia?

Singhal, Shivangi; Verma, Nidhi; Rathi, Monika; Singh, Neha; Singh, Preeti; Sharma, Shipra; Tayal, Uma

doi:10.18203/2320-6012.ijrms20163330

Cited by 8 publications

(9 citation statements)

References 3 publications

(4 reference statements)

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“…Out of the 1000 cases of anemia included in our study, we observed a higher prevalence in females, with 52.7% of the cases being female. This finding is consistent with past research conducted by Singhal et al 13 and Garg et al, 4 where they reported female predominance with 64.9% and 62.9% cases, respectively.…”

Section: Discussionsupporting

confidence: 93%

A comparative study of red cell histogram along with CBC parameters and peripheral blood smear in various anemias

Dhakar,

Rai

2023

IJPO

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: The red blood cell (RBC) parameters generated by cell counters can aid in morphological categorization of anemia, the significance of microscopic analysis of peripheral blood smears (PBSs) cannot be overlooked when it comes to interpreting the underlying cause of anemia. Therefore, both RBC parameters and microscopic examination of PBSs are essential for a comprehensive assessment of anemia.This study aimed to evaluate and compare the results obtained through two different methods: examination of peripheral blood smears (PBS) and automated cell counter generated parameters. The objective was to identify any differences or similarities in the diagnostic outcomes produced by each method. Over the course of one year, from December 2020 to November 2021, a hospital-based, prospective study was conducted. The study aimed to evaluate and compare the PBS findings and RBC parameters and histograms generated by a cell counter in 1000 anemic patients.In a sample of 1000 cases, we compared the typing of anemia using an automated analyzer and peripheral smear examination. Out of these cases, 690 showed consistent typing results between the two methods, while 310 showed discordant typing. The automated analyzer diagnosed majority of cases 70.1% as microcytic anemia and Normocytic, dimorphic, and macrocytic cases were found in 13.5%, 7.8%, and 4.3% of cases, respectively. Additionally, a normal histogram was observed in 17.6% of cases.We have concluded that while the automated analyzer is useful in reducing the overall workload through its graphical representation of anemia typing, it should always be confirmed through microscopy. The automated analyzer is a helpful tool, it should not be relied upon solely for accurate anemia typing. Microscopy remains an essential method for confirming the results of automated analysis.

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Section: Discussionsupporting

confidence: 93%

A comparative study of red cell histogram along with CBC parameters and peripheral blood smear in various anemias

Dhakar,

Rai

2023

IJPO

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“…12 Hence our study showed that PBF provided additional information in only 16% cases of anaemia. This was in concordance with the study conducted by Singal S et al 16 which showed that PBS examination provide additional information only in 11.4% cases of anaemia. Almost similar result was obtained by Froom P et al 17 as PBF provided additional information in 13.9% cases.…”

Section: Discussionsupporting

confidence: 93%

Utility of Peripheral Blood Smear Examination in the Presence of Automated Haematology Analyser with Reference to Anaemia

Hafiz¹,

Salaria²,

Koul³

2019

jemds

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BACKGROUND Anaemia is a global public health problem affecting both developing and developed countries. The morphological typing of anaemia is essential in clinical haematology for diagnostic and treatment purposes. Over the past few years, complete blood count (CBC) by automated haematology analysers and microscopic examination of peripheral smear have complemented each other to provide a comprehensive report on patient's blood sample. Despite this wealth of information, there are still morphological abnormalities that are critical in the differential diagnosis of anaemia and that can be determined only from a blood smear. The present study aims to evaluate the utility of peripheral blood smear examination in presence of automated haematology analyser with reference to anaemia after correlating type of anaemia based on RBC indices obtained from automated haematology analyser and on peripheral blood smear examination. METHODS This is a cross-sectional study conducted for a period of one year from November 1, 2017 to October 31, 2018 on 100 anaemic patients of Government Medical College, Jammu and Associated Hospitals. EDTA anticoagulated samples were received in the laboratory and run on automated haematology analyser to obtain complete blood count including RBC indices. Simultaneously, well prepared and tongue shaped peripheral blood smears stained by Leishman's stain were studied in detail to observe the morphology of red blood cells. RESULTS On classifying anaemias into five major groups, it was seen that there were 40 patients of normocytic normochromic anaemia with normal RDW which correlated well with 40 patients of normocytic normochromic anaemia on peripheral blood film examination. Normocytic hypochromic anaemia with normal RDW was seen in 5 patients, whereas PBF showed normocytic hypochromic anaemia in 7 patients. 31 patients had microcytic hypochromic anaemia (with normal and raised RDW) as per analyser generated indices which correlated well with 29 patients of microcytic hypochromic anaemia on PBF. Both analyser and PBF showed that 10% patients had macrocytic anaemia. Dimorphic anaemia was seen in 14% patients on PBF. Out of 100 cases, 84% (84) of the cases showed concordance in the type of anaemia by analyser generated RBC indices and on peripheral blood film examination. Only 16% cases showed discordance in the type of anaemia which needed peripheral blood film examination for correct morphological classification of anaemia. CONCLUSIONS RBC parameters on analyser along with PBF findings are complimentary to each other rather than being the substitute. PBF is very important in certain clinical settings in patients with normocytic normochromic anaemia with raised RDW, pancytopenia and patients of fever who show normal or slightly abnormal parameters on analyser. Each haematology report has to be interpreted along with clinical presentation of the patient in order to arrive at diagnosis.

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“…The total number of cases of anemia in our study was 1000. Female predominance was observed in the present study with 61% of the cases which was comparable to the past similar research of Singhal et al, (64.9%) 6 and Garg et al, (62.9%). 7…”

Section: Sex Distributionsupporting

confidence: 92%

Correlation of automated cell counter RBC histograms and peripheral smear in anemia typing

Meena¹,

CS²,

Gupta³

et al. 2023

Asian J Med Sci

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Background: Red blood cell (RBC) indices and histogram obtained from automated hematology gives an idea about the morphological changes in anemia and therefore forms the fundamental process for diagnosis of anemia. Along with the peripheral smear, they can be used for anemia typing and to interpret the cause of anemia. Aims and Objectives: (1) Interpretation of histograms in normal persons and patients with different types of anemia. (2) Anemia typing based on RBC histograms complemented with Peripheral smear examination. Materials and Methods: The present prospective study is conducted in Haematology section of Department of Pathology, Shyam Shah Medical College and Sanjay Gandhi Medical Hospital Rewa, Madhya Pradesh. A total of 1000 patients blood sample is collected for complete blood count and anemia typing irrespective of age and gender and examined over a period of 1 year from August 2021 to July 2022. The patient’s blood sample is collected in EDTA vacutainer and analyzed on the basis of histogram obtained and peripheral smear slide prepared. Results: In the present study, we noted that the predominant age group affected was 20–30 years. Peripheral smear finding shows normocytic normochromic anemia was seen in 6% cases (60/1000), microcytic hypochromic anemia seen in 24.2% cases (242/1000), macrocytic anemia seen in 14% cases (140/1000), dimorphic anemia seen in 50.2% cases (502/1000), and hemolytic anemia seen in 5.6% cases (56/1000). This peripheral smear finding shows well correlation with findings of histogram pattern and RBC indices, where normocytic normochromic seen in 6.4% of cases (64/1000), microcytic hypochromic anemia seen in 24.4% of cases (244/1000), macrocytic anemia seen in 13.8% of cases (138/1000), dimorphic anemia seen in 49.5% of cases (495/1000), and hemolytic anemia seen in 5.9% of cases (59/1000). The most common anemia is dimorphic anemia (combined nutritional deficiency) in 49.5% cases followed by microcytic hypochromic anemia in 24.4% of cases based on histogram findings along with RBC indices. Conclusion: Histogram guides a technologist about the cases that need actual detailed peripheral smear examination by experts. Our study shows a well correlation in findings of automated hematology analyzer with the microscopic examination. Histogram alone could be used as screening method and when combined with peripheral blood smear findings, they act as useful supplement and by correlating findings of both methods, we could diagnose majority of anemia.

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Can peripheral blood smear examination be totally replaced by automated hematology analyser - with special reference to anemia?

Cited by 8 publications

References 3 publications

A comparative study of red cell histogram along with CBC parameters and peripheral blood smear in various anemias

A comparative study of red cell histogram along with CBC parameters and peripheral blood smear in various anemias

Utility of Peripheral Blood Smear Examination in the Presence of Automated Haematology Analyser with Reference to Anaemia

Correlation of automated cell counter RBC histograms and peripheral smear in anemia typing

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