冷凝集对血细胞分析多项参数检测结果的影响

目的 探讨红细胞冷凝集对血细胞分析各项检测参数的影响及处理方法.方法 选择福建省肿瘤医院2017年12月至2020年2月有红细胞冷凝集的全血标本73份.应用Sysmex XN-9000全自动血细胞分析仪对标本进行检测,比较37℃水浴前后红细胞(RBC)、血细胞比容(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白...     

Correlations between changes in hematological indices of mothers with preeclampsia and umbilical cord blood of newborns

Preeclampsia is a condition that might severely impact the health of mothers and their newborns. The aim of this investigation is to examine hematological parameters in mothers with preeclampsia and umbilical cord blood. Eighty preecalmptic mothers were recruited in the study. In addition, eighty normal pregnant mothers served as controls. Hematological parameters that include hemoglobin (Hb), red blood cell count (RBC), red cell distribution width (RDW), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell counts (WBC), platelet counts, mean platelet volume (MPV) and Platelet large cell ratio (PLCR) were examined. Results showed a strong association between preeclampsia and low birth weight, premature/cesarean delivery and proteinuria (P < 0.001). Hb and neutrophils were significantly lower (P < 0.01), whereas RDW, PCV, MCV, MCH, MCHC and lymphocytes were significantly higher than normal ones (P < 0.01). When cord blood of preeclamptic mothers were compared with that of normal ones, similar findings were observed. In addition, results showed significant and positive correlations between preeclamptic mothers and their newborn in Hb (r2 = 0.075, P < 0.05), PCV (r2 = 0.084, P < 0.01), MCV (r2 = 0.077, P < 0.05), MCHC (r2 = 0.115, P < 0.01), RBC (r2 = 0.086, P < 0.01) and retics (r2 = 0.306, P < 0.01). In conclusion, changes in several hematological parameters associated with preeclampsia were correlated in affected mothers and their newborns. Such biomarkers can be used to predict pregnancy outcomes in women with preeclampsia.     

Characteristics of red blood cell populations fractionated with a combination of counterflow centrifugation and Percoll separation.

Red blood cell (RBC) fractions were studied after separation of whole blood by means of counterflow centrifugation, Percoll column (Pharmacia, Uppsala, Sweden), and a combination of both separation techniques. Mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), and hemoglobin A1c (HbA1c) were measured in each fraction. From the results it was obvious that the combination of both techniques was the best separation technique of these three. MCV had a good correlation with cell age as measured with HbA1c concentration gradient; MCH and MCHC less so. MCV and MCH decreased in parallel to an increase in HbA1c. MCHC increased with increasing HbA1c. From these data it is concluded that there is a steadily ongoing loss of cellular hemoglobin and proportionally more cellular water during the life of the RBC.     

Postnatal ontogeny of erythropoietin and hematology in free-ranging Steller sea lions (Eumetopias jubatus)

The hormone erythropoietin (EPO) is responsible for the increased production of red blood cells (RBC) in response to tissue hypoxia. While the role of EPO in hematological development has been established in humans and terrestrial mammals, this relationship has never been examined in marine mammals that rely heavily on stored oxygen to maintain aerobic metabolism while diving. Since blood is the major oxygen storage site in marine mammals, it was hypothesized that EPO may have a significant influence on the development of hematology parameters associated with the expansion of blood oxygen stores during development. To explore this hypothesis, serum EPO concentrations were determined by radioimmunoassay in 235 free-ranging Steller sea lions (Eumetopias jubatus), throughout their Alaskan range. Hematocrit (Hct), hemoglobin (Hb), and red blood cell (RBC) counts were also measured, and mean corpuscular hemoglobin content (MCHC), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCV) values determined. Erythropoietin and most hematological parameters varied with age. Hematocrit, Hb, RBC, and MCHC decreased after birth, reached their lowest values at two to three months of age, and then increased to values similar to those of adults by five months of age. Since changes in Hct and Hb account for the majority of the changes in blood oxygen stores and EPO was negatively correlated with both, it appears that EPO may play an important role in blood development of Steller sea lions, similar to previous studies on terrestrial mammals.     

Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on hemoglobin levels and mean corpuscular volume

The average results of some laboratory measurements, including the hemoglobin, mean corpuscular volume (MCV), serum transferrin saturation (TS), serum ferritin, and white blood cell count of African-Americans differ from those of whites. Anonymized samples and laboratory data from 1491 African-American and 31 005 white subjects, approximately equally divided between men and women, were analyzed. The hematocrit, hemoglobin, MCV, TS, and white blood cell counts of African-Americans were lower than those of whites; serum ferritin levels were higher. When iron-deficient patients were eliminated from consideration the differences in hematocrit, hemoglobin, and MCV among women were slightly less. The -3.7-kilobase alpha-thalassemia deletion accounted for about one third of the difference in the hemoglobin levels of African-Americans and whites and neither sickle trait nor elevated creatinine levels had an effect. Among all subjects, 19.8% of African-American women would have been classified as "anemic" compared with 5.3% of whites. Among men, the figures were 17.7% and 7.6%. Without iron-deficient or thalassemic subjects, the difference had narrowed to 6.1% and 2.77% and to 4.29% and 3.6%, respectively. Physicians need to take into account that the same reference standards for hemoglobin, hematocrit, MCV, and TS and the white blood cell count do not apply to all ethnic groups.     

Use of capillary blood count parameters in adults

BACKGROUND AND OBJECTIVES: Capillary samples can provide blood for cell counts in haematologic patients and blood donors. However, some accept only values from venous blood. This study compares capillary and venous blood counts to verify the hypothesis that they are equivalent. MATERIALS AND METHODS: We analysed 463 capillary (fingerstick) and venous blood samples from 428 adults of both sexes (71% haematologic patients, 29% potential blood and apheresis donors). Both samples were taken at the same time from each subject. Haemoglobin (Hb), haematocrit (Hct), white blood cells (WBC), platelets, red blood cells (RBC), mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were measured using a haematology analyser (Advia 120, Bayer). RESULTS: Capillary Hb, Hct, WBC, RBC, MCV and MCH were all significantly higher than the venous values [+0.2 mmol/l (+0.3 g/dl), +0.02 l/l (+2%), +0.2 x 10(9)/l, +0.1 x 10(12)/l, +3.1 fl and +0.01 fmol, respectively], whereas the capillary MCHC was lower (-0.6 mmol/l). There was no difference in platelets (-1 x 10(9)/l). Capillary Hb and Hct values were higher in patients with anaemia and polycythaemia, respectively. However, no significant differences occurred in severe thrombocytopenia. CONCLUSION: In adult haematologic patients, however, only the differences in Hb and Hct values may be of clinical relevance. For potential blood and apheresis donors, Hb and platelet screening are equivalent with either capillary and venous blood using a haematology analyser.     

OSAHS患儿血FIB、RBC相关指标变化及其临床意义探讨

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿血纤维蛋白原(FIB)、红细胞计数(RBC)相关指标变化及其临床意义.方法 回顾性分析2018年1月～2020年5月医院收治的90例OS-AHS患儿的资料,记为A组,另回顾性分析同期在该院体检的84例健康儿童的资料,记为B组.对比A组和B组血FIB、RBC、血红...     

Reference intervals of complete blood count constituents are highly correlated to waist circumference: Should obese patients have their own “normal values?”

Body mass index (BMI), the prevalent indicator of obesity, is not easily grasped by patients nor physicians. Waist circumference (WC) is correlated to obesity, is better understood and has a stronger relationship to the metabolic syndrome. We compiled WC, complete blood count (CBC) parameters as well as other pertinent data of 6766 25–55‐year‐old US volunteers sampled in the US National Health and Nutrition Examination Survey, in the years 2005–2010. To determine reference intervals of typical US patients visiting their clinician, we used minimal exclusion criteria. We compiled hemoglobin, red blood cell count, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration, mean cell hemoglobin (MCH), red cell distribution width (RDW), platelet count, mean platelet volume, and counts of white blood cells (WBC), neutrophils, lymphocytes, monocytes, eosinophils, and basophils. In addition, we also compiled serum C reactive protein and serum iron. The three major US races were studied and reference interval diagrams were constructed for each CBC parameter plotted against WC. WBC count, RDW, lymphocyte, neutrophil, and red blood cell count increase with WC. Conversely, serum iron and MCH and MCV decrease. These relationships may be related to insulin resistance and chronic activation of the immune system and the resulting low‐grade inflammatory state. WC is a strong predictor for many CBC parameters, suggesting that WC should be taken into account when evaluating blood count results. Clinicians who take care of obese patients should be aware of altered hematology and investigate and treat accordingly. Am. J. Hematol. 89:671–677, 2014. © 2014 Wiley Periodicals, Inc.     

Whole blood viscosity and erythrocyte hematometric indices in chronic heroin addicts

Whole blood viscosity (WBV) and hematometric indices of erythrocytes as red blood cell count (RBC), mean erythrocyte volume (MCV), hemoglobin (HGB), hematocrit (HCT), mean hemoglobin content of erythrocytes (MCH), HGB/HCT values (MCHC) and red blood cell distribution width (RDW) have been studied in a group of 15 chronic opioid addicts under methadone maintenance therapy with mean age 26.53 +/- 7.34 years. WBV elevation and changes in MCV, HGB, HCT, RDW were found in intravenous drug users compared to healthy individuals. As well, RBC was decreased leading to an increase in MCH and MCHC values. Correlation analysis suggested that the correlation among the RBC, HGB, HCT and WBV was the closest. Heroin macrocytosis (heroin macrocytic anemia) was established, related with the increased RDW in chronic heroin abusers. The results are in accordance with data revealing abnormal effects of alcohol and other drugs on whole blood rheology and hematometric/morphometric characteristics of erythrocytes.     

Studies on blood rheology in patients with primary pulmonary hypertension

The rheologic properties of blood were studied in 6 patients with primary pulmonary hypertension (PPH) and compared with those of a control group of 10 healthy subjects. Blood viscosity was studied with a rotational viscometer and blood cell deformability with a filtrometer giving values for clogging particles (CP) and red cell transit time (RCTT). Blood viscosity at varying shear rates was found to be increased both at natural (p less than 0.025-0.005) and standardized hematocrit, 45% (p less than 0.05 at 40 s-1) in patients with PPH. Red cell deformability was reduced as indicated by a significant increase of RCTT (p less than 0.01). Increased values for hematocrit (p less than 0.001), hemoglobin concentration (p less than 0.001), and erythrocyte count (p less than 0.005) were found and decreased values for mean corpuscular hemoglobin concentration (MCHC) (p less than 0.025) and HDL cholesterol (p less than 0.005). Plasma viscosity, white cell deformability, white cell count, mean corpuscular volume (MCV), and plasma fibrinogen concentration did not significantly differ from the values found in the control group. It is concluded that patients with PPH have impaired blood rheology. The hemorheologic abnormalities in these patients may be of hemodynamic significance.     

贵州省毕节市燃煤型氟中毒地区人群血常规分析

目的 通过贵州省毕节市燃煤型地方性氟中毒地区汉族人群血常规调查,了解其健康状况及所存在问题.方法 在贵州省毕节市燃煤污染型地氟病病区,对已改良炉灶的长春镇长春村的全体居民(干预组)和未改良炉灶的鸭池镇十八村的全体居民(非干预组)进行血常规检查,检查指标包括白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、红细胞平均压积体积(MCV)、平均红细胞血红蛋白(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW-CV)、血小板(PLT).结果 在男性中,干预组RBC、Hb、HCT、MCHC、PLT分别为(4.95±1.18)×1012/,L、(138.46±15.90)g/L、(50.19±11.48)%、(284.90±48.73)g/L、(334.92±119.34)× 109/L,非干预组分别为(4.02±0.47)x 1012/L、(131.00±15.90)g/L、(40.90±7.60)%、(323.14±41.95)g/L、(280.79±100.34)×109/L,组间比较差异均有统计学意义(U值分别为7.72、3.50、7.12、6.28、3.66.P＜0.01.);在女性中,干预组RBC、HCT、MCV、MCH、MCHC、RDW-CV、PLT分别为(4.75±1.20)×1012/L、(46.91±11.20)%、(99.30±6.88)f1、(28.10±8.66)pg、(275.61±54.49)g/L、(16.95±1.63)%、(351.23±150.37)×109/L,非干预组分别为(3.85±0.65)×1012/L、(38.80±6.60)%、(100.80±7.00)f1、(33.10±5.40)pg、(327.14±44.52)g/L、(16.60±1.58)%、(279.40±98.07)×109/L,组间比较差异有均统计学意义(U值分别为8.92、10.72、2.04、6.61、9.82、2.06、5.39,P＜0.01或＜0.05).非干预组的RBC和Hb异常率[32.62%(92/282)、16.67%(47/282)]高于干预组[9.73%(29/298)、6.71%(20/298)],组问比较差异均有统计学意义(x2值分别为45.992、14.054,P＜0.01).结论 氟中毒病区干预组人群血常规检查情况优于非干预组,尤其是干预组的贫血情况改善较好.     

Hand strike-induced hemolysis and adaptations in iron metabolism in Basque ball players

INTRODUCTION: Basque ball players (BBPs) make repeated hand strikes to the ball which involves continuous mechanical trauma. OBJECTIVE: The aim of this work is to describe the hematological variations and changes in iron metabolism occurring in BBPs as a result of acute and continuous practice of this special sport native to Northern Spain. METHODS: 40 healthy male subjects volunteered to participate in this study: 11 subjects who exercise moderately (control group) but do not play Basque ball sport and 29 professional BBPs were studied in two situations: before a match (BM group) and after a match (AM group). The following hematological parameters were determined: red blood cell count (RBC), hemoglobin and hematocrit; MCV, MCH and MCHC. The following variables were measured in serum: iron, ferritin, transferrin, transferrin saturation, proteins, and lactate dehydrogenase (LDH). Proteins and hemoglobin were determined in urine. RESULTS: The BM group showed lower hematocrit, MCV, hemoglobin and serum transferrin levels, and higher LDH than controls. The AM group showed higher RBC, hemoglobin, serum proteins, iron, transferrin and LDH levels, lower plasma volume, and higher urine hemoglobin and protein levels than the BM group. CONCLUSIONS: Basque ball playing induces hemolysis and increases the plasma capability to quench free iron, but its clinical consequences on iron metabolism do not seem to be enough to take an iron intake proportional to the caloric intake. In order to prevent, in the long term, the development of anemia in these peculiar sportsmen, it would be useful that medical teams observe urine blood losses and oxidative stress in these BBPs.     

Is analysis of the reticulocyte haemoglobin equivalent a useful test for the diagnosis of iron deficiency anaemia in geriatric patients?

BackgroundIron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) are common in elderly patients but there are no standard diagnostic criteria. The reticulocyte haemoglobin equivalent (Ret-He) is routinely measured by modern automated blood analysers and is an early indicator of iron deficiency. The aim of this study was to investigate whether the Ret-He level as calculated by the Sysmex XE-5000 automated blood analyser is a useful parameter for the diagnosis of IDA in a geriatric hospitalized population.MethodsIn a prospective study, blood samples were collected in 26 geriatric patients with IDA and 111 patients with ACD diagnosed according to generally accepted laboratory and clinical criteria. A blood count including Ret-He, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and standard iron parameters was performed in each patient.ResultsHaemoglobin, Ret-He, MCV, MCH and MCHC levels were all significantly lower in IDA as compared to ACD patients. However, the area under the curve (AUC) was greater for MCH (0.87, 95% CI 0.78–0.95) and MCHC (0.86, 95% CI 0.76–0.96) then for Ret-He (0.828, 95% CI 0.73–0.93) and MCV (0.80, 95% CI 0.68–0.91). A Ret-He cut-off value of 26 pg had a sensitivity and specificity based on its optimal combination of 85% and 69% respectively.ConclusionAnalysis of Ret-He does not perform better than the classical red cell indices such as MCH and MCHC in differentiating IDA and ACD in geriatric patients.     

Three New Hemoglobin Variants with Abnormal Oxygen Affinity: Hb Saratoga Springs [α40(C5)Lys→Asn (α1)], Hb Santa Clara [β97(FG4)His→Asn], and Hb Sparta [β103(G5)Phe→Val]

Abstract

β-Thalassemia (β-thal) and iron deficiency cause most microcytic anemias. Red cell indices and formulas have been established as simple, fast, and inexpensive in discrimination between these two hematological disorders in school children. However, whether these formulas could be applied to diagnose β-thal trait and iron deficiency in adult Thai subjects is unclear. The aim of this study was to examine the diagnostic accuracy of five red cell indices [red blood cell (RBC) counts, mean corpuscular volume (MCV), mean corpuscular hemoglobin (Hb) (MCH), mean corpuscular Hb concentration (MCHC), and red cell distribution width (RDW)] and nine formulas (RDW/RBC, RDW Index, Sirdah, Green and King, Mentzer, England and Fraser, Ehsani, Srivastava and Shine and Lal). Their sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV), efficiency, and Youden’s Index were analyzed in 102 β-thal trait and 64 iron deficiency adult Thai subjects. The RDW/RBC formula proved to be the most reliable index as they had 100.0% specificity and PPV and the highest efficiency (94.58%) and Youden’s Index (91.18%), as well as high sensitivity (91.18%) and NPV (87.67%). Therefore, this formula could be used in initial discrimination of β-thal trait from iron deficiency in adult Thai subjects.     

Effects of hydroxyurea on hemoglobin F and water content in the red blood cells of dogs and of patients with sickle cell anemia.

A rationale for clinical trials of hydroxyurea (HU) treatment in sickle cell disease is that the agent increases red blood cell (RBC) fetal hemoglobin content. However, an additional effect of HU is to raise the mean corpuscular volume (MCV). To investigate the action of HU in a species that makes no electrophoretically distinguishable fetal hemoglobin, we treated dogs with the drug and compared their response to that of five patients with sickle cell anemia. Both dogs and patients had an increase in MCV, but the effect of HU treatment on the mean corpuscular hemoglobin concentration (MCHC), density, and water content of the RBCs differed in the two species. The dog RBCs became low in MCHC, high in ion and water content, and low in mean density. Thus, HU can raise MCV and lower MCHC without influencing fetal hemoglobin synthesis. A different pattern was seen in the sickle cell patients during HU treatment. Although the MCV of their RBCs increased, there was no change in MCHC, ion content, or mean density. A notable change in the sickle cell patients' blood was that two subpopulations of cells were nearly eliminated during HU treatment; the hypodense reticulocyte fraction and the hyperdense fraction that contains irreversibly sickled cells. These findings lead us to suggest that trials of HU in sickle cell disease must recognize the possibility that any beneficial effect of this agent might be due not only to an increase in hemoglobin F alone, but perhaps also to the associated increase in MCV or the altered RBC density profile.     

Causes of microcytic anaemia and evaluation of conventional laboratory parameters in the differentiation of erythrocytic microcytosis in blood donors candidates*

ABSTRACT

Context and Objective: Microcytic anaemia results from defective synthesis of haemoglobin in the erythroid precursors, causing a reduction in its mean corpuscular volume (MCV). The most common causes of microcytosis, without the increase in HbA₂ levels, are iron deficiency anaemia (IDA) and α-thalassemia. The aim of this study was to identify the causes of microcytic anaemia and evaluate the haematological parameters from blood donors deemed ineligible (due to the low haematocrit level) that would differentiate the IDA and α-thal, whether isolated or in association.

Methods: Genomic DNA was submitted to the polymerase chain reaction multiplex for the diagnosis of the most common allele deletions of α-thal and erythrogram and in order to verify haematological parameters. Iron deficiency (ID) was determined through the measurement of serum ferritin.

Results: Of the 204 samples, 82 (40.2%) were identified with ID, 24 (17.8%) with α-thal and 10 (4.9%) with ID associated with α-thal. In the α-thal with ID group haemoglobin (Hb), MCV, mean corpuscular Hb concentration (MCHC) and mean corpuscular Hb (MCH) values were significantly lower compared to the isolated α-thal. In the group with ID Hb, MCV, MCHC and MCH values were significantly lower compared to those with isolated α-thal. The α-thal with ID group, showed Hb, MCV, MCHC and MCH significantly reduced when compared to those with IDA.

Conclusions: This study showed that the values of haematological parameters, especially haematocrit, Hb, MCV, MCH, MCHC and red blood cell distribution width (RDW), are lower in patients with IDA, especially when associated with α-thal and therefore it may be useful to discriminate between the different types of microcytic anaemia.     

低剂量亚慢性砷中毒家兔血液常规检查指标观察

目的 观察低剂量亚慢性砷中毒家兔血液常规检查指标的变化,为筛选低砷暴露的早期损伤指标提供依据.方法 将12只健康雄性家兔按体质量随机分为对照组和3个亚砷酸钠(NaAsO2)染毒组(低、中、高剂量组),每组3只.对照组家兔饮用自来水,3个染毒组分别饮用含砷量为10、50、250μg/L的自来水溶液.8周时于家兔耳缘静脉取50μl抗凝血,用ABX-60型全自动血细胞分析仪测定白细胞系统[白细胞(WBC)、淋巴细胞绝对值(LYM)、淋巴细胞百分比(LYM%)、中性粒细胞绝对值(GRA)、中性粒细胞百分比(GRA%)、单核细胞绝对值(MON)、单核细胞百分比(MON%)]、红细胞系统[红细胞(RBC)、血红蛋白(HGB)、红细胞比积(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW)]、血小板系统[血小板(PLT)、平均血小板体积(MPV)、血小板压积(PCT)和血小板分布宽度(PDW)],共18项指标.结果 各染毒组WBC、GRA、GRA%与对照组相比有升高趋势,但差异无统计学意义(P>0.05);各组间PLT、MPV比较,差异有统计学意义(F值分别为4.07、4.20,P<0.05),其中高剂量组PLT[(221.33±22.50)×109L]明显低于对照组[(292.00±16.97)×109/L,P<0.05],中剂量组MPV[(5.57±0.46)fL]也明显低于对照组[(7.10±0.99)fL,P<0.05];其余指标变化不明显.结论 低剂量亚慢性砷中毒可造成家兔血液系统改变,血液常规检查可作为砷中毒的早期损伤指标.     

Red blood cell indices as an effective marker for the existence and severity of endometriosis (STROBE)

To evaluate the association between red blood cell (RBC) indices (mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH], MCH concentration [MCHC], red cell distribution width [RDW], hemoglobin [Hb], hematocrit [Hct], and neutrophil-to-lymphocyte ratio [NLR]) and the severity of endometriosis.Data were obtained from the medical records of 200 patients with endometriosis (stage I/II and stage III/IV groups), and 100 patients with benign ovarian tumors (control group), treated between September 2011 and April 2021.The mean Hb and Hct were significantly lower in the stage III/IV group compared to those in the control and stage I/II group (P = .015 and P = .004, respectively). The mean MCV, MCH, and Hb at postoperative day (POD)#1 were significantly lower in the stage III/IV group compared to those in the control and stage I/II group (P = .007, P = .032, and P < .0001, respectively). In addition, NLR at POD#1 was significantly higher in stage III/IV group compared to that in the control and stage I/II group. Multivariate analysis revealed that younger age (≤38 years old), lower preoperative MCV (≤88.5 fL), lower POD#1 Hb (<11.6g/dL), and higher POD#1 NLR (>2.5) were independent risk factors of stage III/IV endometriosis.Lower levels of RBC indices, including preoperative MCV and postoperative Hb, and higher postoperative NLR were significantly associated with the severity of endometriosis, which is potentially derived from a dysregulation in iron metabolism and inflammation.     

Screening and Diagnosis of Hb Quong Sze [HBA2: c.377T > C (or HBA1)] in a Prenatal Control Program for Thalassemia

Hb Quong Sze [Hb QS, HBA2: c.377T?>?C (or HBA1)] is a common nondeletional thalassemia in southern China. It is one of the major alleles causing nondeletional Hb H (β4) disease in the Chinese population. There is no strategy currently in place that aims to screen using hematological index cutoffs for this variant. This study was carried out to evaluate whether it is effective to use mean corpuscular hemoglobin (MCH) <27.0?pg as a screening test in the first step of screening for Hb QS carriers in southern China. The data of hematological testing in the Hb QS carriers obtained from couples who underwent prenatal thalassemia screening, regardless of the red blood cell (RBC) indices, were retrospectively reviewed. A total of 51 Hb QS carriers were identified, giving a prevalence rate of 0.2%; among these, 45 were Hb QS heterozygotes. The values of hemoglobin (Hb), MCV and mean corpuscular Hb (MCH) in the 45 Hb QS heterozygotes were 13.2?±?1.8?g/dL, 75.2?±?3.3?fL and 24.5?±?0.5?pg, respectively. Eight heterozygotes (17.8%) had an MCV value of >80.0?fL, ranging from 80.9 to 84.1?fL, and would not be detected using the cutoff value of MCV <80.0?fL as a criterion for thalassemia screening. However, if screening had been based on the MCH <27.0?pg value, all 45 Hb QS heterozygotes would have been detected. Using a cutoff value of MCH <27.0?pg in nondeletional thalassemia screening would greatly decrease the DNA diagnosis burden.     

Sample stability for complete blood cell count using the Sysmex XN haematological analyser

Background

Sample stability is a crucial aspect for the quality of results of a haematology laboratory. This study was conducted to investigate the reliability of haematological testing using Sysmex XN in samples stored for up to 24 h at different temperatures.

Materials and methods

Haematological tests were performed on whole blood samples collected from 16 ostensibly healthy outpatients immediately after collection and 3 h, 6 h or 24 h afterwards, with triple aliquots kept at room temperature, 4 °C or 37 °C.

Results

No meaningful bias was observed after 3 h under different storage conditions, except for red blood cell distribution width (RDW) and platelet count (impedance technique, PLT-I) at 37 °C. After 6 h, meaningful bias was observed for mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) at room temperature, red blood cell (RBC) count, mean corpuscular haemoglobin concentration (MCHC), MCH, MCV and PLT-I at 4 °C, and RBC, RDW, MCHC, MCH and PLT-I at 37 °C. After 24 h, a meaningful bias was observed for MCHC, MCV, platelet count (fluorescent technique, PLT-F) and mean platelet volume (MPV) at room temperature, MCHC, MCV, PLT-I and MPV at 4 °C, and all parameters except RBC count and MPV at 37 °C.

Discussion

Great caution should be observed when analysing results of haematological tests conducted more than 3 h after sample collection.