Comparison of Automated Analyzer Generated Red Blood Cell Parameters and Histogram with Peripheral Smear in the Diagnosis of Anaemia

Abstract

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.

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

“…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.…”

“…3 The RBC histogram is generated by the automated hematology analyzer, which uses sophisticated technology to measure the size and number of red blood cells in the blood sample. 4 The normal histogram curve generated by the automated hematology analyzer is typically bell-shaped and symmetrical, indicating a Gaussian distribution. This normal curve represents the range of mean corpuscular volume (MCV) between 80-100fl.…”

“…Causes may be due to inadequate dietary intake, increased demand mainly in pregnancy and lactation, poor absorption from gut, chronic blood loss, etc. 4 Shifting of RBC histogram depends on the size of RBC; when the RBC size is microcytic, histogram shifts toward left while the presence of macrocytes causes shift of RBC histogram toward the right. Microcytic hypochromic anemia causes decrease in MCH and MCV which causes left shift of RBC histogram.…”

A Cross-Sectional Study of Hematological Parameters in the Geriatric Population Using Peripheral Smear Examination and a Five-Part Cell Counter

“…A total blood count test can give an overview of the patient's general health state because abnormal blood counts can be an indication of the existence of many different diseases [ 6 ]. Using advanced hematology analyzers and a traditional microscopic examination of a peripheral blood smear might reveal vital details about a patient's clinical status [ 7 ].…”

Correlation of RBC indices and RBC histogram obtained by automated hematology analyser with peripheral smear in the diagnosis of anemia

“…The conventional microscopic examination of peripheral smear for red blood cell morphology provides crucial information about the patient's clinical condition and has always been the cornerstone of diagnostic haematology. 1 However, laboratory haematology has been labour intensive and time consuming. 2 Over the past few years, complete blood count by the automated haematology analyser and peripheral blood smear have complemented each other to provide a comprehensive report on the patient's blood sample.…”