Percentage of hyperdense cells: Automated parameter to hereditary spherocytosis screening

Farias, Mariela Granero; Freitas, Priscila Aparecida Corrêa

doi:10.1016/j.clinbiochem.2015.07.025

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…We found that FC OF test presents even better laboratory parameters (AUC) in screening for thalassemia than HS. The high utility of the test in thalassemia diagnosis was also found by Farias and Freitas . In our study, sensitivity of FC OF for thalassemia diagnostics was 94.74%, while Mohapatra et al reported 98.33% for β‐ and 100% for α‐thalassemia traits.…”

Section: Discussionsupporting

confidence: 79%

Flow cytometric osmotic fragility test: Increased assay sensitivity for clinical application in pediatric hematology

Ciepiela

Adamowicz-Salach

Zgodzińska

et al. 2017

Cytometry Part B Clinical

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Background: Osmotic fragility test (OFT) is widely considered as a sensitive indicator of red blood cells' sensitivity to the hypotonic solution. It is often used as a screening test for the diagnosis of hereditary spherocytosis (HS). Nowadays, the osmotic fragility test based on flow cytometric analysis (FCM OF) is widely used in laboratory practice. The purpose of this study was to optimize the assay sensitivity and to validate its clinical application in the diagnostic screening of childhood anemias.Methods: The study was conducted on 175 children suffering from various types of anemia (including 30 children with proven hereditary spherocytosis, HS) and 16 healthy subjects. All children were aged between 3 months and 17 years, including 94 boys and 97 girls. FCM OF was performed on every subject according to two different analysis time patterns (hemolysis was analyzed for 214 or 300 s) using Cytomics FC500 flow cytometer.Results: Significant higher sensitivity was demonstrated by the tests carried out according to the longer analysis time pattern (90.0 vs. 83.33%). The level of specificity of both the analysis patterns was similar. When an extended analysis time was used, the percentage of red cell survival levels in HS patients were significantly lowered compared to the same cases analyzed with shorter incubation times and all other non-HS anemic cases (9.31 6 4.69 vs. 35.59 6 15.30%, P < 0.05). During the shorter analysis time, the values obtained were 13.76 6 7.92% for HS and 48.18 6 19.04% for non-HS, P < 0.0001. The 300-s test is very useful in distinguishing thalassemia patients from patients with other types of anemias (94.74% sensitivity and 90.12% specificity) and provided the values of remaining red blood cells as 70.46 6 12.29% for thalassemia and 27.16 6 13.01% for nonthalassemia subjects, P < 0.0001. Conclusion: Flow cytometric osmotic fragility test with a longer (300-s) analysis time demonstrated an increased sensitivity in detecting HS in anemic children. V C 2017 International Clinical Cytometry Society

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Section: Discussionsupporting

confidence: 79%

Flow cytometric osmotic fragility test: Increased assay sensitivity for clinical application in pediatric hematology

Ciepiela

Adamowicz-Salach

Zgodzińska

et al. 2017

Cytometry Part B Clinical

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“…In another study of 58 patients with HS, the authors found that %Hyper cut-off of 6.4% showed a sensitivity of 92.3% and specificity of 90.7% to detect HS [20]. The minimum percentage of hyperchromic cells in patients with HS seen in our study was 6.3%.…”

Section: Discussionsupporting

confidence: 54%

“…In approximately 20% of the diagnosis is missed [5]. In such cases, flow cytometric OFT and eosin-5′-maleimide dye-binding tests have a better sensitivity than conventional OFT [19,20]. Identification of the causative mutation, currently based on the whole-exome sequencing method, can provide a definite diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Utility of hyperchromic cell percentage, flags, and red cell cytograms generated by Advia-120 hematology analyzer as a potential screening tool in hereditary spherocytosis

2020

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Hereditary spherocytosis (HS) is the commonest inherited red cell membrane disorder seen in clinical practice. Modern hematology analyzers generate newer parameters that can help in screening of HS. The present study focuses on the utility of red blood cell data generated by Advia-120 hematology analyzer as a screening tool for patients with HS. Blood samples from 21 patients with HS were analyzed on Advia-120 (Technicon H*1 series) analyzer. The percentage of hyperchromic cells and hyperchromic and hemoglobin concentration variance flags along with the RBC cytogram were studied. A control group of 50 healthy individuals and 50 patients with other hematological disorders was also studied. Osmotic fragility test was done in all patients with suspected HS. All hematological parameters including percentage of hyperchromic red cells were compared between the study group, healthy controls, and other hematological disorders. Twenty of the 21 patients with HS were anemic. Peripheral blood smear in all patients showed variable numbers of spherocytes (5-50%). Osmotic fragility test was positive in all patients. The mean percentage of hyperchromic cells in patients with HS-18.2 ± 13.0% was significantly higher (p < 0.0001) than that seen in the control group and in patients with other hematological disorders. Hyperchromic RBC > 6% showed a sensitivity of 100% and specificity of 99% for the diagnosis of HS. All patients showed flagging for hyperchromic cells. The RBC cytograms in all 21 patients showed significant number of RBCs plotted in the hyperchromic zone. The percentage of hyperchromic cells, hyperchromic cell flagging, and RBC cytogram pattern generated by Advia-120 hematology analyzer are useful tools in the screening of patients with suspected HS.

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“…Other parameters measured in regard to reticulocytes are the Hypo-He and Hyper-He indices, which discriminate RBCs with low and high hemoglobin concentrations, respectively. Individuals with HS have a higher Hyper-He count, which is associated with the increased number of microcytic erythrocytes (MicroR), an index measured exclusively by the Sysmex analyzer (15,24,25). Persijn et al proposed that the threshold for the MicroR value be decreased from ≥3.5% to ≥2.6% to discriminate between HS and non-HS subjects, which would significantly increase the sensitivity of the test (26).…”

Section: Complete Blood Count (Cbc) Analysismentioning

confidence: 99%

Old and new insights into the diagnosis of hereditary spherocytosis

Ciepiela¹

2018

Ann. Transl. Med.

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Hereditary spherocytosis (HS) belongs to the group of congenital hemolytic anemias resulting from plasma membrane protein deficiency. When diagnosed too late, HS bares the risk of long-term complications including gall stones and severe anemia. Here, there are discussed advances in HS screening and diagnostics, with a particular focus on methodologies, most of which are available in clinical laboratories worldwide.

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Percentage of hyperdense cells: Automated parameter to hereditary spherocytosis screening

Cited by 6 publications

References 14 publications

Flow cytometric osmotic fragility test: Increased assay sensitivity for clinical application in pediatric hematology

Flow cytometric osmotic fragility test: Increased assay sensitivity for clinical application in pediatric hematology

Utility of hyperchromic cell percentage, flags, and red cell cytograms generated by Advia-120 hematology analyzer as a potential screening tool in hereditary spherocytosis

Old and new insights into the diagnosis of hereditary spherocytosis

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