DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163330

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

Shivangi Singhal, Nidhi Verma, Monika Rathi, Neha Singh, Preeti Singh, S. P. Sharma, Uma Tayal

Abstract


Background: The aims and objectives of present study was to correlate typing of anemia based on RBC indices obtained from an automated analyzer with peripheral blood smear (PBS) examination and also to find out whether the number of PBS examination can be reduced with the help of automated hematology analyzer.

Methods: A total of 2500 blood samples showing anemia as per WHO reference range were collected in central pathology lab of SVBP Hospital attached to L.L.R.M. Medical College, Meerut, Uttar Pradesh, India over a period of one year. Samples were reported by auto-analyzer and PBS examination simultaneously.

Results: Out of total 2500 cases, there were 1623 females (64.9%) and 877 males (35.1%) with male: female ratio 0.54:1. By auto-analyzer and PBS examination, MCHC anemia (49.8%) was the commonest anemia followed by NCNC anemia (36.5%) and Macrocytic anemia (4.2%). Discordant typing of anemia between two methods was found in 284 (11.4%) cases only. These cases were diagnosed as normocytic normochromic (NCNC) anemia with raised RDW by autoanalyzer while as Dimorphic Anemia (DA) on PBS examination. Also morphological changes such as RBC inclusions, spherocytes, RBC fragments, schistocytes, nucleated RBCs were seen only on PBS examination.

Conclusions: The Study concluded that even today PBS examination is very important and cannot be totally replaced by automated analyzer and both methods are complementary to each other.


Keywords


Automated hematology analyzer, Peripheral blood smear, Examination, Anemia

Full Text:

PDF

References


Mohammed EA, Mohamed MMA, Far BH, Christopher Naugler Calgary Laboratory Services, University of Calgary, Calgary, Alberta athol Inform. 2014;5:9.

Jen P, Woo B, Rosenthal PE, Bunn HF, Loscalzo A, Goldman L. The value of the peripheral blood smear in anemic inpatients. The laboratory's reading v a physician's reading. Arch Intern Med. 1983;143(6):1120-5.

Bourner G, Dhaliwal J, Sumner J. Performance evaluation of the latest fully Automated hematology analyzers in a large, commercial laboratory setting: a 4-way, side-by-side study. Lab Hematol. 2005;11(4):285-97.

Chapman M. Hematology analyzers offer new technology and user-friendliness. Lab Med. 2000;31:146-150.

Lantis KL, Harris RJ, DAvis G, Renner N, Finn WG. Elimination of instrument-driven reflex manual differential leucocyte counts. Optimization of manual blood smear review criteria in a high-volume automated hematology laboratory. Am J Clin Pathol. 2003;119(5):656-62.

Swaroop Raj BV, Sunita BS, Vanmalinitewari, Divya C. Is peripheral smear examination an obsolete art? Inter J Rec Scie Res. 2015;6(3):3059-62.

Joshi P, Joseph D, Bajpai P, Manoria P, Joshi P, Yadav V, Dagore H, Jha RK. Prevalence of anemia in general population of Malwa (MP) India. J Med Dent Rese Scie. 2013.

Mukaya JE, Ddungu H, Ssali F, O‘Shea T, Crowther MA. Prevalence and morphological types of anaemia and hookworm infestation in the medical Emergency ward, Mulago Hospital, UganDA S Afr Med J. 2009;99:881-6.

NFHS-3 (2007), Govt of India website. http; www.nfhs.india. org/ abt.html.

Sandhya I, Muhasin T. Study of RBC histogram in various anemias. Journal of Evolution of Medical and Dental Sciences. 2014;3(74):15521-34.

Verma M, Chhatwal J, Kaur G. Prevalence of anemia among urban school children of Punjab. Indian Pediatr. 1998;35:1181-6.

Kumari S, Choudhary AK, Negi G. Prevalence of anemia among the general population of Bihar, India. Ind Med Gaz. 2009;11:418-21.

Froom P, Havis R, Barak M. The rate of MAnual peripheral blood smear reviews in outpatients. Clin Chem Lab Med. 2009;47(11):1401-5.

Novis DS, Walsh M, Wilkinson D, St Louis M, Ben-Ezra J. Laboratory productivity and the rate of MAnual blood smear review: College of American Pathologist Q-Probes Study of 95,141 complete blood count determinations performed in 263 institutions. Arch Pathol Lab Med. 2006,130(5):596-601.

Djulbegovic B. Red blood cell problems. In: Djulbegovic B, ed. Reasoning and Decision MAking in HeMAtology. Edinburgh, UK: Churchill Livingstone. 1992:13.