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Background: The study was done to investigate whether the raised levels of C-reactive protein (CRP), differential count and random blood glucose, besides echocardiogram, enhances the assessment process of acute coronary syndrome (ACS).Methods: This prospective study was done on 100 patients with typical chest pain attending to the department of medicine at K.A.P.V Medical College and Hospital, Trichy during the period from 2015 to 2017. The serum was assayed on admission for CRP, differential count and random blood glucose. Correlation of these parameters with incidence of ACS was calculated.Results: Male preponderance was seen in the study. Out of 100 patients, majority of about 60% of ACS patients had raised JVP. Elevated level of CRP was seen in 73% patients, 70% had elevated level of ejection fraction percentage. 71% had elevated level of WBC and 58% had elevated level of RBS. Statistically significant correlation was observed with the level of CRP (p=0.044), differential WBC count (p=0.037) and random blood glucose levels (p=0.001).Conclusions: Our study indicates that elevated CRP levels, increased random blood sugars and leucocytosis in ACS patient are positively correlated with decreased ejection fraction. Hence, measuring the levels of these parameters will helps in identifying incidence of acute coronary syndrome without echocardiogram.
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Background: The normal physiological range for white blood cells and differential count are essential for diagnosis, treatment, follow up and screening. This study aimed at establishing the reference ranges of WBCs and differential count in Sudanese people.Methods: The present study included 444 healthy adult Sudanese from both sexes with age range of 20 – 60 years. Blood samples were obtained from brachial veins and drawn in EDTA tubes. WBCs and differential count were analyzed using Sysmex KX-21 automated hematology analyzer. Full clinical examination was performed, weight and height were measured, and BMI was calculated.Results: The mean WBC count was 5.1±1.5×103/ µl with a range of 3.6 ×103/µl to 6.6 ×103/µl. The mean WBCs count for males and females were 4.969×103/µl and 5.138×103/µl respectively. Neutrophils count was 2.430×103/µl (47%) and mean for lymphocyte count was 2.116×103/µl (41.1%).Conclusions: WBCs count was directly proportional to BMI. The WBCs count of Sudanese people was lower than that of Caucasians and similar to reports from other African countries.
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Manual microscopic differential of white blood cell has been challenged by multiparameter flow cytometry,using monoclonal antibodies to define the different leukocyte types.Compared with manual differential,flow cytometry method is more sensitive,specific,objective and has good repeatability.Recent studies demonstrated flow cytometric differential correlates well with manual microscopic method and has good clinical performance for blast and immature granulocyte.Meanwhile more leukocyte populations can be identified with flow cytometric method,such as lymphocyte subset and CD 16 + monocyte,thus helping in monitoring blast in acute leukemia,B lymphocyte proliferative disorder differential diagnosis and minimal residual disease.With the development and improvement of flow cytometric differential,it might be a candidate reference method of leukocyte differential,gradually applied in the routine work.
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Objective Inflammation response is involved in the whole pathological process of acute cerebral infarction ( ACI) , but few reports are seen on its clinical implication in ACI patients .The purpose of this study was to investigate the predictive value of the differential count of leukocytes for stroke severity and early clinical outcomes in the acute phase of cerebral infarction . Methods We collected the clinical and laboratory data of 635 patients diagnosed with ACI within 72 hours of symptom onset and eval-uated the association between the differential count of peripheral blood leukocytes and stroke severity at admission and within 3 days af-ter admission as well as the clinical outcomes at discharge .The neural function impairment scores of the patients were obtained with The NIH Stroke Score ( NIHSS) at admission and on the third day after admission , and the therapeutic results evaluated with the modi-fied Rankin Scale ( mRS) , mRS >2 as poor prognosis .Analyses were performed on the correlation of the differential count of leuko-cytes with NIHSS and mRS scores and its influence on the ACI patients . Results At discharge , the mRS related influencing factors included the total count of leukocytes (OR=1.147, 95% CI:1.038-1.268), count of neutrophil cells (OR=1.227, 95% CI:1.00-1.369 ), count of lymphocytes ( OR =0.508, 95% CI:0.342-0.753), and neutrophil to lymphocyte ratio (NLR) (OR=1.150, 95%CI:1.008-1.314).the NIHSSs were correlated with the counts of leucocytes (r=0.078, P=0.024), neutrophil cells (r=0.083, P=0.019), and lymphocytes (r=0.010, P=0.004) at admission, and with the counts of leucocytes ( r =0.238, P <0.001), neutrophil cells (r=0.335, P<0.001), lymphocytes (r=-0.269, P<0.001), and NLR (r=0.423, P<0.001) on the third day after admission. Conclusion In the acute phase of cer-ebral infarction , the differential count of leukocytes and NLR are valuable for predicting the severity of neurologic impairment and early poor functional outcome .
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AIMS: The aim of the present study is to investigate systemic levels of inflammatory markers of cardiovascular diseases like C-reactive protein (CRP), interleukin-6 (IL-6), total leukocyte count and differential count in patients with chronic periodontitis, in comparison to healthy individuals without periodontal disease. SUBJECTS AND METHODS: A total of 42 individuals, both males and females, above the age of 30 years, were included. Healthy controls (Group I, n = 14), patients with chronic localized periodontitis (Group II, n = 14) and chronic generalized periodontitis (Group III, n = 14), all without any other medical disorder were recruited and peripheral blood samples were taken. Serum samples of CRP and IL-6 were estimated by using different techniques. Total leukocyte count and differential count were estimated by standard clinical laboratory method. RESULTS: Groups II and III had higher mean CRP levels than Group I (0.479, 0.544 versus 0.304 mg/dL). C-reactive protein level in Group III was statistically significant when compared to Group I (p = 0.04). Group III had higher median IL-6 level (6.35 pgm/ml) than Group II (< 5.0 pgm/ml) and Group I (< 5.0 pgm/ml). Median values of IL-6 were not statistically significant in any group (p = 0.29). Total leukocyte count was also elevated in Group III (10.4 x 10³/c.mm) compared to Group II and Group I (9.2 x 10³/c.mm and 7.9 x 10³/c.mm). This was statistically significant between different study groups (p < 0.0001). Neutrophil count in Group III was higher (68.0%) than Group II (62.4%) and Group I (57.4%). Neutrophil percentage was statistically significant in Group III, when compared to Group I (p = 0.0003). CONCLUSION: Periodontitis results in higher systemic levels of CRP, IL-6, total leukocyte count and neutrophils. These elevated inflammatory factors may increase inflammatory activity in atherosclerotic lesions, potentially increasing the risk for cardiovascular events.
OBJETIVOS: El objetivo del presente estudio es investigar los niveles sistémicos de los marcadores inflamatorios de enfermedades cardiovasculares, como la proteína C-reactiva (PCR), la interleucina-6 (IL-6), el conteo total de leucocitos, y el conteo diferencial en los pacientes con periodontitis crónica, en comparación con individuos saludables sin la enfermedad periodontal. SUJETOS Y MÉTODOS: El estudio comprendió un total de 42 individuos - varones y hembras - mayores de 30 años de edad. Los controles saludables (Grupo I, un = 14), los individuos con periodontitis crónica localizada (Grupo II, n = 14), y aquellos con periodontitis crónica generalizada (Grupo III, n = 14), todos sin ningún otro problema médico, fueron reclutados y se tomaron muestras de sangre periférica. Las muestras de suero de PCR e IL-6 fueron estimadas usando técnicas diferentes. El conteo total de leucocitos y el conteo diferencial fueron calculados mediante el método estándar de laboratorio clínico. RESULTADOS: Los grupos II y III tuvieron niveles promedio más altos de PCR que el Grupo I (0.479, 0.544 frente a 0.304 mg/dL). El nivel de proteína C-reactiva en el Grupo III fue estadísticamente significativo, comparado con el Grupo I (p = 0.04). El Grupo III tuvo un nivel mediano más alto de IL-6 (6.35 pgm/ml) que el Grupo II (< 5.0 pgm/ml) y el Grupo I (< 5.0 pgm/ml). Los valores medianos de IL-6 no fueron estadísticamente significativos en ningún grupo (p = 0.29). El conteo total de leucocitos también fue elevado en el Grupo III (10.4 x 10³/c.mm) comparado con el Grupo II y el Grupo I (9.2 x 10³/c.mm y 7.9 x 10³/c.mm). Dicho conteo fue estadísticamente significativo entre diferentes grupos de estudio (p < 0.0001). El conteo de neutrófilos en el Grupo III fue más alto (68.0%) que en el Grupo II (62.4%) y el Grupo I (57.4%). El porcentaje de neutrófilos fue estadísticamente significativo en el Grupo III, en comparación con el Grupo I (p = 0.0003). CONCLUSIÓN: La periodontitis produce niveles sistémicos más altos de PCR, IL-6, conteo total de leucocitos y neutrófilos. Estos factores inflamatorios elevados pueden aumentar la actividad inflamatoria en las lesiones ateroscleróticas, aumentando potencialmente el riesgo de accidentes cardiovasculares.
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Adult , Female , Humans , Male , C-Reactive Protein/metabolism , Chronic Periodontitis/blood , /blood , Case-Control Studies , India , Leukocyte Count , NeutrophilsABSTRACT
Objective To explore the values of potential clinical application ofsingle tube/ten colorsflow cytometry for leukocyte differential count in peripheral blood.Methods Utilizing multiple monoclonal antibody combinations and the vavious logical gating strategies,the single tube/12 antibodies with no-wash method for the leukocyte differential count in peripheral blood were determined by using 10 colors flow cytometry.Leukocyte differentials of 142 peripheral blood samples were determined by both Beckman-Coulter LH750 hematology analyzer and 10 colors flow cytometry.The results were then compared to standard microscopic examination as a reference method.The clinical diagnostic efficiency ofsingle tube/10 colorsflow cytometry was calculated.The correlations between standard microscopic cytology,single tube/10 colorsflow cytometry and the hematology analyzer were determined.In addition,the clinical diagnosis efficiency for blast counts ofsingle tube/10 colorswere compared to the results determined by BD FACS Calibur flow cytometer.Results The leukocyte differentials were correlated well between the single tube/10 colorsflow cytometry and standard microscopic cytology(r>0.700,P<0.01) except for basophils.The correlations with neutrophilic granulocytes,lymphocytes,immature granulocytes and blasts were superior(r=0.972,0.951,0.801,0.912,respectively,P<0.01).When 1% was selected as the cut-off point for immature granulocytes determined by standard microscopic cytology,the sensitivity and the specificity ofsingle tube/10 colorsflow cytometry were 92%(57/62) and 79% (63/80),respectively.When 0.5% was selected as the cut-off point for blasts detected by standard microscopic cytology,the sensitivity and the specificity were 99% (67/68) and 92% (68/74).Using the immunophenotyping results from BD FACS Calibur as a standard,the sensitivity for detecting blasts bysingle tube/10 colOrsflow cytometry was 100% (40/40),the specificity was 91% (10/11),the positive predictive value was 98% (40/41),the negative predictive value was 100% (10/10) and the accuracy was 98% (50/51).Conclusions Thesingle tube/10 colorsflow cytometry has a excellent correlation with the standard microscopic cytology when applied on leukocyte differential count in peripheral blood.It may potentially use as a subsequent method for verification of abnormal results of complete blood cell count in the future.
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INTRODUCTION: The ABX Pentra DX 120 (Pentra DX 120, ABX Diagnostics, Montpellier, France) adopted new technologies to perform differential leukocyte and erythroblast counts. The double matrix can discriminate Large Immature Cell (LIC), Immature Granulocyte (IMG), Immature Monocyte (IMM), Immature Lymphocyte (IML), and Atypical lymphocyte (ALY) in addition to a routine 5-differential count. For erythroblast (ERB), a fluorescence method is employed. In this study, we evaluated the performance of the Pentra DX 120 in the performance of differential leukocyte and erythroblast counts. METHODS: Precision was evaluated using 3-level control materials. Comparison analysis was performed on 200 samples: 100 normal and 100 abnormal samples. We evaluated the 5 part differential count, LIC, IMG, IMM, IML, ALY, and ERB. These parameters were analyzed in comparison with the results from the reference method, manual differential count. RESULTS: The coefficients of variation (CVs) of precision were 0.9 except monocytes and basophils. IMG, ALY and erythroblasts were also well correlated with manual count (r=0.8315, 0.5602, 0.8144, respectively). The efficiency of flagging system was 84% for LIC, 80% for ALY, and 78.0% for increased ERB (>2/100WBCs). CONCLUSIONS: The Pentra DX 120 performed reliable differential leukocyte and IMG, ALY, and ERB results demonstrated comparable performance to manual count. And, the flagging system was efficient for detecting each abnormal cell population. We expect the Pentra DX 120 double matrix and erythroblast count can reduce microscopic review rate in routine laboratory and promote laboratory efficiency.
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Basophils , Eosinophils , Erythroblasts , Fluorescence , Granulocytes , Leukocytes , Lymphocytes , Monocytes , NeutrophilsABSTRACT
BACKGROUND: Recent advances of hematology analyzers have improved performance of leukocyte differential counts and have reduced work load of clinical hematology laboratories. We evaluated CELL-DYN Sapphire (Abbott Diagnostics, Santa Clara, CA, USA) performance on leukocyte differential counts according to Clinical and Laboratory Standards Institute (CLSI) document H20-A. METHODS: We evaluated imprecision (short term imprecision from duplication of 147 patients' sample and long term imprecision from three level commercial controls) and accuracy (n=462) of leukocyte differential counts of CELL-DYN Sapphire and compared with those of Sysmex XE-2100 (TOA Medical Electronics Co., Kobe, Japan), ADVIA 120 (Bayer Diagnostics, Tarrytown, NY, USA) and Beckman Coulter LH 750 (Beckman Coulter, Miami, FL, USA). RESULTS: The imprecision of CELL-DYN Sapphire for neutrophils and lymphocytes differentials was low with coefficients of variation (CV) from 1.4 to 6.2%, but the imprecision for basophils was high with CV from 34.7 to 79.6%. The correlation with manual count was good in samples without flags (n=314), with the exception of basophils (r: neutrophils, 0.921; lymphocytes, 0.921; monocytes, 0.653; eosinophils, 0.869; basophils 0.272). The correlation with other hematology analyzers was high except basophils (r: neutrophils, 0.969-0.986; lymphocytes, 0.986-0.990; monocytes, 0.787-0.887; eosinophils, 0.881-0.962; basophils 0.086-0.327). CONCLUSION: The performance on leukocyte differential counts of CELL-DYN Sapphire is comparable to Sysmex XE-2100, ADVIA 120 and Beckman Coulter LH 750. In regards of enumeration of basophils, the comparison with manual counts and other hematology analyzers shows poor agreement.
Subject(s)
Aluminum Oxide , Basophils , Electronics, Medical , Eosinophils , Hematology , Leukocytes , Lymphocytes , Monocytes , NeutrophilsABSTRACT
Objective To evaluate the influence of the storing time of venous blood samples on the differential count of WBC by Sysmex XE-2100 hematology analyzer. Methods At room temperature, the precision of the differential count of WBC by Sysmex XE-2100 hematology analyzer were tested. 38 samples were taken the differential count of WBC by Sysmex XE-2100 hematology analyzer after stored for 0, 2, 4, 8, 24 and 48 h. Differential count of WBC was also taken under microscope for comparison. Results The precision of differential count of WBC by Sysmex XE-2100for all the samples was in the allowable range. The correlation coefficient of the differential count of WBC by two methods for neutrophils, lymphocytes, monocytes, eosinophils and basophils were 0.9859, 0.9775, 0.8053, 0.8695and 0.5243 (P<0.01). There was insignificant difference in the test at 8h, very significant difference of MONO and EOS at 48 h. Differences of EOS, MONO between two methods were significant increased at 8 h. Conclusion At room temperature, the differential count of WBC of venous blood samples by Sysmex XE-2100 hematology analyzer should finish within 8 h.