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Blood transfusion service is a vital part of our health care system. Stringent blood donor screening and medical examination plays a vital role in maintaining the quality and safety of blood components. Voluntary non-remunerated blood donors form the backbone of blood transfusion services. However, regular donation by such voluntary donors may cause significant depletion of iron stores in the body. This has the potential to adversely affect the donor's health, and also to lower the quality of blood being collected subsequently. Even though a pre-donation hemoglobin estimation is routinely done in blood centres, it may fail to recognize subclinical iron store depletion. Testing Ferritin level of all donors is not cost effective and practical in resource limited centres. This study was aimed to identify any significant changes in hematological parameters over repeated blood donations, that may point towards a potential Iron deficiency in an otherwise healthy donor. This was a cross sectional study involving 138 whole blood donors who had attended the blood centre, Department of Transfusion Medicine, Government Medical college, Thiruvananthapuram. The study subjects were categorized into 2 groups based on the number of donations and a Complete blood count (CBC) was done for each group. Data was analyzed using SPSS software, quantitative variables expressed as Mean and Standard Deviation, p value <0.05 was considered statistically significant. Results were analysed by Independent Samples T test. Statistically significant variables were further analysed using Kruskal-Wallis test. Second time blood donors constituted major part of sample size (20/138). Mean Hemoglobin value showed no significant change among the two donor categories. Mean corpuscular volume (MCV) of repeat whole blood donors is significantly lower than infrequent donors independent samples T test, tvalue=3.309. (p-value=0.001). Donors were further subdivided into 5 groups in the order of increasing number of donations and significant difference was observed in MCV and proved by Kruskal-Wallis test(H=19.1344) As per our study, a significant reduction in MCV among repeat donors with a normal hemoglobin value compared to infrequent donors. This might point towards an impending Iron deficiency anemia in near future. A prompt detection of subclinical iron deficiency in voluntary blood donors is the need of the hour since it can cause adverse consequences in donor health and can considerably lower the donor availability as well. Blood centres should take measures like routine Iron stores evaluation of regular repeat donors, educating donors regarding the importance of maintaing a healthy diet, Iron tablet supplementation to prevent donor Iron deficiency anemia (IDA) etc.
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Anaemia is a disease of low erythrocyte count and haemoglobin (Hb) concentration less than the normal range. The main causes of anaemia are a decrease in RBCs, their destruction and decrease of Hb synthesis. A useful method for diagnosis and classification of anaemias is based on the morphological appearance of RBCs on an ideal stained blood smear. The main terms used in such classification are normocytic normochromic, microcytic hypochromic and macrocytic anaemia. In general, microcytic hypochromic anaemias are caused by reduced haemoglobin synthesis (most commonly because of iron deficiency), while macrocytic anaemias caused by reduced DNA synthesis that impair the maturation of erythroid precursors in the bone marrow. Normocytic normochromic anaemias have diverse aetiologies; in some of these anaemias, specific abnormalities of red cell size and shape which is best appreciated through visual inspection of peripheral smears provide an important clue as to cause.METHODSRetrospectively and prospectively we evaluated the results of complete blood count (CBC) and peripheral blood picture (PBP) of all anaemic patients attending during the year 2018 (from 1st January to 31st December), in the Department of Pathology, Gandhi Medical College, Bhopal (M.P.).RESULTSOut of a total of 500 patients, 220 were males and 280 were females. Results of CBC and PBP showed that 145 (29%), 275 (55%) and 80 (18%) of the patients had normocytic normochromic, microcytic hypochromic and macrocytic pattern of anaemia respectively.CONCLUSIONSThe microcytic hypochromic pattern of anaemia is highly frequent among this sample of patients while the macrocytic pattern of anaemia is the lowest. According to gender groups, microcytic hypochromic pattern of anaemia is more common among females; malnutrition, increase of blood loss due to pregnancy or menstruation, and lack of iron absorption are the main causes, while the normocytic normochromic anaemia is highly prevalent among males, which is mainly due to blood loss or chronic diseases.
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Background: Nutritional anemia is a worldwide problem with the highest prevalence in the developing countries. One of the most vulnerable groups is 6-24 months of age. NFHS-3 survey shows that the incidence of anemia in children aged 6-35 months is 79.2% with 72.7% in urban areas and 81.2% in rural areas. First stage of iron deficiency is depletion of iron stores, which is reflected by decreased serum ferritin levels and increased total iron binding capacity (TIBC) levels. The objective of this study was to detect presence of iron deficiency in children even before clinical appearance of anemia by measuring serum ferritin levels.Methods: The study was conducted from March 2017 to November 2017 in the Department of Pediatrics of Sir Sayajirao Gaekwad General Hospital, a tertiary level hospital and government medical college, Vadodara. A cross sectional study was done in which a total of 111 asymptomatic infants and toddlers in age group of 6-24 months presenting to well-baby clinic were enrolled randomly. Haemoglobin, RBC indices and serum ferritin levels were estimated. The children were classified into mild, moderate and severe anaemia according to their haemoglobin levels. Correlation with their serum ferritin levels was carried out by using statistical analysis.Results: Prevalence of anaemia (Hb <11gm/dl) was 84.14% in 6-12 months age group, 81.25% in 13-18 months age group and 84.61% in case of 19-24 months age group. Overall 83.78% of infants and toddlers were found to be anemic among 6-24 months age group. 55 infants (49.54%) among 111 infants had mild anaemia, 29 infants (26.12%) had moderate anaemia, 9 infants (8.1%) had severe anaemia. Majority of children (87 of 111 infants) had microcytic and hypochromic RBCs in their peripheral smear examination. 78 infants (72.07%)) had low serum Ferritin levels while only 31 infants had normal ferritin levels which is statistically significant (p=0.0084). Out of these, 4 infants had normal hemoglobin level.Conclusions: Anaemia is highly prevalent in the age group of 6 to 24 months even in otherwise healthy infants. Serum ferritin level is a good indicator of iron deficiency in children.
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Background@#Anemia is a major global problem that affects women and prevalent during pregnancy. Effective management is needed to prevent adverse maternal and pregnancy outcomes. Ferrous iron salts are the preparation of choice and recommended for both prevention and treatment of iron deficiency anemia (IDA). However, most commonly available iron supplement are poorly absorbed, with gastrointestinal disturbances as side effect.@*Objective@#To compare the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of IDA among pregnant women seen at the out-patient department of a tertiary medical center.@*Methodology@#This study is a single blind randomized clinical trial which included women 18 to 40 years old, with singleton pregnancies diagnosed with IDA without any co-existing fetal and maternal complications seen at the OutPatient Department. Forty eight eligible participants were randomized, with 24 women allocated on each treatment arm who took their assigned treatment twice a day for 90 days. Hemoglobin, hematocrit, MCHC, MCV, RDW & serum ferritin levels were taken at baseline and monitored on days 30, 60 and 90 from initiation of treatment. Mean blood parameters between two treatment arms were compared on days 30, 60 and 90 post-treatment as well as the mean difference of blood parameters on days post-treatment from the baseline using T-test. Chi-square was used to compare adverse effects between two treatment arms.@*Results@#No statistically significant differences in the mean blood parameters on days 30 and 60 of treatment between Iron amino acid chelate and Ferrous sulfate. It was only on day 90 from initiation of treatment when there were a significantly higher hematocrit and MCHC and lower RDW in Iron amino acid chelate compared to Ferrous sulfate group. All of the CBC parameters on days 30, 60, and 90 post-treatment when compared to baseline level were significantly increased for both treatment arms. However, day 90 level of serum ferritin in the Iron amino acid chelate group significantly increased unlike those in ferrous sulfate group.@*Conclusion@#Iron amino acid chelate is comparable to Ferrous sulfate in the treatment of IDA among pregnant women. Iron amino acid chelate was found to be superior to Ferrous sulfate in achieving optimum treatment response even at a lower dose with lesser adverse effects. Hence, better oral iron treatment tolerability, thereby, compliance to long-term therapy can be expected resulting to successful treatment outcome.
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Hemoglobins , HematocritABSTRACT
Objective To evaluate the influence of the mean corpuscular volume (MCV) in different ranges on PLT counts,provide the theoretical basis for making PLT counts review rules in laboratory.Methods From March 2016 to August 2016 in Xijing Hospital department of outpatient who perform complete blood cell count were randomly divided into 3 groups,MCV≤65 fl in A group,65 fl＜MCV≤70 fl in B group and 70 fl＜MCV≤75 fl in C group.The reference method (Coulter principle) compared with the fluorescence method,accuracy analysis of different monitoring methods of counting PLT.Results PLT I and PLT F count values in A group was (322.8± 109.1) × 109/L and (282.60± 100.5) × 109/L respectively,and there was significant differences between the two groups (t=6.799,P＜0.05).In B group,the count values was (305.7 ± 111.7)× 109/L and (304.8 ± 112.3)× 109/L respectively,and there was no differences between two groups.In C group,the count values was (292.2±84.4) × 109/L and (291.6±84.4) × 109/L respectively,and there was no differcnces between two groups neither.Conclusion When small red blood cells or blood cell debris present in blood circulation,MCV≤65 fl,the reference testing (Coulter principle)of platelets causes a false increase in platelet count.
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Objective To study the clinical diagnostic value of MCV, MCH and RDW in children with iron deficiency anemia.Methods40 cases of children with iron deficiency anemia in our hospital from May 2014 to May 2016, were selected as iron deficiency anemia group, another 40 healthy children were chosen in our hospital underwent the healthy control group, using imported reagent in 2h in the MCV, MCH and RDW index value is read out, and then the children of the two groups of MCV, MCH and RDW values were statistically analyzed.ResultsThe levels of iron, and zinc in children with iron deficiency anemia were significantly lower than those in healthy control group (P<0.05), but there was no significant difference in copper, calcium and magnesium levels between the two groups;The MCV and MCH values of children with iron deficiency anemia group were significantly lower than those in healthy control group (P<0.05),the RDW value was significantly higher than that in healthy control group (P<0.05).ConclusionMCV, MCH and RDW detection for clinical diagnosis of iron deficiency anemia in children is high, can be an effective basis for clinical prevention and early diagnosis and treatment of iron deficiency anemia in children, it is worthy of clinical application.
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Background: The aim of this study was to find out the changes in blood parameters in a group of myocardial infarction patients in Jamnagar, Gujarat. Methods: In this cross sectional study conducted at the medicine clinic in GGH general hospital, Jamnagar between May 2012 and April 2013, a total of 100 subjects were included. Parameters like hemoglobin, RBC count, WBC count, platelet count, hematocrit, ESR, Mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, packed cell volume, differential WBC count used. Results: The results of present study revealed that WBC count, ESR, the differential leukocyte count (e.g. neutrophil cells) in patients increased significantly (P <0.01) comparison to controls. While, the differential leukocyte count of lymphocyte & platelet count revealed to decrease significantly (P <0.01) in patients. Conclusion: Abnormal blood parameters are more common among diabetes patients. Elevated WBC count, ESR, neutrophils are present in patients as compared to control. While decreased in lymphocytes & platelets are seen in patients as compared to control.
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Objective To evaluate the immunization coverage of the first dose of measles containing vaccine (MCV1 )by using the incidence of measles in Wenzhou City.Methods Descriptive epidemiological methods were used to analyze measles cases that reported in Wenzhou city from 2007 to 2012 and evaluate the immunization coverage of the first dose of measles containing vaccine.Results The average annual incidence rate was 10.46/100 000 from 2007 to 2012,and the annual incidence rate was 43.44/100 000 for children aged from 8 months to 83 months (42.59%).Based on the proportion of immunized measles cases vaccine effectiveness (VE)of MCV,the evaluated coverage rate of MCV1 was 73.80% (VE=90%)or 84.92% (VE=95%)in children aged from 13 to 83 months.The evaluated coverage rate of MCV1 was 83.25%(VE=90%)or 90.86%(VE=95%)in local children and 69.5 1%(VE=90%)or 82.02%(VE=95%)in migrating children.The timely immunization rate of MCV1 was 59.48% (VE =90%)or 74.59% (VE =95%).Conclusion The coverage rate and timely coverage rate of MCV1 are still low.It is important to strengthen the management of migrating population and enhance propaganda to ensure a high level vaccination rate to accelerate the elimination of measles.
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Objective: Combined detection of anti-mutated citrullinated vimentin ( anti-MCV ) antibodies, anti-cyclic citrullinated peptide ( anti-CCP) antibodies and rheumatoid factor ( RF-IgM) levels to investigate the diagnostic value of anti-mutated citrullinated vimentin (anti-MCV) antibodies for rheumatoid arthritis(RA).Methods: A total of 359 patients with RA,128 patients with other rheumatic diseases and 90 healthy controls were involved.Enzyme linked immunosorbent assay ( ELISA) was used to detect anti-MCV and anti-CCP, and dynamic immune nephelometry was applied to detect RF-IgM .The sensitivity and specificity were obtained from the experimental data.Results:The sensitivities of anti-MCV,anti-CCP and RF-IgM were 85.1%,76.7% and 82.7%in RA respectively.The specificities were 93.2%,95.1%and 80.1%respectively.Combined detection of anti-MCV and anti-CCP,the sensitivity decreased to 70.2%; but the specificity increased to 98.7%.The sensitivity reached to 89.5% with specificity 97.6%when the union of anti-MCV and anti-CCP positivity was used as criterion.Conclusion:Anti-MCV and anti-CCP are novel makers for RA diagnosis with high sensitivity and high specificity.Combination of anti-MCV and anti-CCP is more helpful for RA diagnosis.
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Background: Because of the overlapping MCV, MCH and HbA 2 values in BTT and non-BTT subjects our laboratory determined own cutoffs. Aims: To establish cutoff values by investigating the parents of thalassemia major children and to assess the degree of anemia in BTT subjects. Materials and Methods: Study includes 179 parents of thalassemia major children (BTT cases) and 287 non-BTT controls. Samples were analyzed on an electronic hematology analyzer. The samples having MCV ≤ 76 fl and MCH ≤ 27 pg were quantified for HbA 2 by cellulose acetate electrophoresis and grey zone samples were confirmed on HPLC. Statistical Analysis Mean ± SD, sensitivity, specificity, PPV, NPV and accuracy were calculated. The histograms were plotted for MCV, MCH and HbA 2 . Results: Cases having MCV ≤ 76 fl and MCH ≤ 27 pg if considered as suspected cases of BTT then we could have missed five known BTT samples. Sensitivity increased to 100% in all three diagnostic parameters when the cutoff values were raised and specificity for MCV and MCH was decreased. But specificity was 100% with raised cutoff for HbA 2 . Hb and HCT mean values were significantly reduced in BTT cases compared to controls (P < 0.001). In 100% females and 84.9% males having BTT, mild to moderate anemia was observed. Conclusion: In our setup, the cutoff values are MCV (≤78.0 fl), MCH (≤28 pg) and HbA 2 (>3.8%) for BTT diagnosis and there is a mild to moderate anemia in BTT cases.
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Alcoholism is a serious health issue with major socioeconomic consequences. Significant morbidity is related to chronic alcohol use, and alcoholics seek advice only when complications of drinking set in. The diagnosis is often based on patients self-reporting of alcohol consumption, which is unreliable and requires high degree of clinical suspicion. However, if alcohol problems are recognized at an early stage, the physician may be able to prevent their further development and progression. The present study compares the mean corpuscular volume (MCV) with other traditional biochemical markers in alcohol abuse patients and healthy controls. It is a prospective study, and 40 cases and 30 controls were evaluated for biochemical parameters over a period of one year. The study revealed MCV to be possessing 87.5% sensitivity, 83.33% specificity, 87.5% of positive predictive value, 48.39% of negative predictive value and 54.29% of diagnostic accuracy, which makes it a reliable marker. The mean gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) concentrations in alcohol dependent subjects were higher as compared to controls. Though clinical histories and questionnaires are the commonest initial means of detection of alcohol abuse, laboratory markers such as MCV should be used for confirming the diagnosis of alcohol abuse. They are also helpful in follow-up of patients undergoing treatment, and monitoring of abstinence
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@#Objective To investigate the effect of ultrashort wave therapy on motor conduction velocity (MCV) and expression of vascular endothelial growth factor (VEGF) in rats with sciatic nerve injury.MethodsThe models of peripheral nerve injury were established by forceps clip of sciatic nerve and then a total of 60 SD rats were divided randomly into three groups, including experimental group (n=24), control group (n=24) and sham operation group(n=12). The rats of experimental group were treated by ultrashort wave therapy after operation. The injured sciatic nerve and spinal cord in waist were sampled at the 1st，2nd，4th，6th week respectively after operation and were observed by electrophysiology and immunohistochemistry.ResultsAfter operation，the MCV of sciatic nerve in both experimental group rats and control group rats is zero in 1st week. Since 2nd week，the MCV of sciatic nerve in rats of both two groups began to arise and the MCV of injuried sciatic nerve in rats of experimental group was higher than that in the control group (P<0.05). In injured spinal cord motoneuron，the Integrated Optical Density(IOD) of VEGF in experimental group was higher than that in the control group (P<0.05).ConclusionUltrashort wave therapy could increase the value of MCV of sciatic nerve and the expression of VEGF in spinal cord in rats,and so it could protect the injured peripheral nerve.
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Physical training induces beneficial adaptation, whereas exhaustive exercises increase reactive oxygen-species generation, thereby causing oxidative damage in plasma and erythrocytes, fractions susceptible to lipid peroxidation. Pequi (Caryocar brasiliense Camb.) is a Brazilian Cerrado fruit containing a carotenoid-rich oil. The aim was to investigate the effects of pequi-oil on exercise-induced oxidative damage in plasma and erythrocytes, after running in the same environment and undergoing weekly training under the same conditions as to type, intensity and length. Evaluations were accomplished after outdoor running on flat land before and after ingestion of 400 mg pequi-oil capsules for 14 days. Blood samples were taken after running and submitted to TBARS assay and erythrogram analysis. Haptoglobin, MnSOD (Val9Ala), CAT (21A/T) and GPX1 (Pro198Leu) gene polymorphisms were priorly investigated, so as to estimate genetic influence The reduction in erythrocytes, hemoglobin and hematocrit after pequi-oil treatment was notably associated with higher plasma expansion. Except for MCHC (mean corpuscular hemoglobin concentration) and RDW (red cell distribution width), the results were influenced by the polymorphisms studied. The best response to pequi-oil was presented by MnSOD Val/Val, CAT AA or AT genotypes and the GPX1 Pro allele. The significantly lower RDW and higher MHCH values were related to pequi-oil protective effects. Pequi oil, besides possessing other nutritional properties, showed protective blood effects.
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OBJECTIVE: Serologic support is important for the diagnosis of rheumatoid arthritis (RA). Anti-cyclic citrullinated peptide (anti-CCP) has relatively low sensitivity despite of high specificity for the diagnosis of RA. Anti-mutated citrullinated vimentin (anti-MCV) is an indirect solid phase enzyme immunoassay for the quantitative measeurement of IgG class autoantibodies against MCV, a novel serologic marker for an aid in the diagnosis of RA. We investigated a diagnostic value of anti-MCV in comparison with those of anti-CCP, and rheumatoid factors (IgM, IgG, and IgA RFs) in RA patients. METHODS: Cohorts of 48 patients with RA and 50 patients with osteoarthritis (OA) were enrolled. All patients underwent standard examinations, including anti-MCV, anti-CCP, IgM RF, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). We measured IgG RF and IgA RF titers in 21 RA and 50 OA patients. The sensitivities and specificities of anti-MCV, anti-CCP, RFs were determined. Correlations with these markers, ESR and CRP were analyzed. RESULTS: The sensitivity of anti-MCV, anti-CCP, and IgM RF were 89.6%, 89.6%, and 77.1%, respectively. The specificities of them were 96.0%, 96.0%, and 88%, respectively. Combination of two tests such as anti-MCV or anti-CCP positivity increased the sensitivity up to 93.8%. None of these markers showed significant correlation with ESR and CRP. Anti-MCV correlated with anti-CCP (r=0.596, p<0.01) and IgM RF (r=0.301, p=0.038). CONCLUSION: Anti-MCV and anti-CCP showed high sensitivity and specificity for the diagnosis of RA. Combination of these markers increased the sensitivity without significant decrease in the specificity, suggesting they may be promising serologic markers for RA.
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Humans , Arthritis, Rheumatoid , Autoantibodies , Blood Sedimentation , C-Reactive Protein , Cohort Studies , Diagnosis , Immunoenzyme Techniques , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M , Osteoarthritis , Rheumatoid Factor , Sensitivity and Specificity , VimentinABSTRACT
Simultaneous deficiency of Vitamin B12 and iron induces that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce hypochromic microcytic erythrocytes. We report two cases of Vitamin B12 deficiency anemia with low mean corpuscular volume (MCV) due to combined iron deficiency anemia with review of literature.
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Anemia , Anemia, Iron-Deficiency , Bone Marrow , Erythrocyte Indices , Erythrocytes , Iron , Masks , Vitamin B 12 Deficiency , Vitamin B 12 , VitaminsABSTRACT
Simultaneous deficiency of Vitamin B12 and iron induces that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce hypochromic microcytic erythrocytes. We report two cases of Vitamin B12 deficiency anemia with low mean corpuscular volume (MCV) due to combined iron deficiency anemia with review of literature.
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Anemia , Anemia, Iron-Deficiency , Bone Marrow , Erythrocyte Indices , Erythrocytes , Iron , Masks , Vitamin B 12 Deficiency , Vitamin B 12 , VitaminsABSTRACT
The purposes of this retrospective study were to assess the change of serum parameters in oral and maxillofacial surgery patients after operation and to determine what laboratory parameters on treatment periods were associated with the recovery of systemic condition. For purposes of assessing systemic nutritional status, several serum parameters were chosen. The sample patients were randomsubjects extracted from three category patient groups- oral cancer, odontogenic abscess, facial bone fracture based on treated patients at department of oral and maxillofacial surgery in Pusan National University Hospital from September 1, 1998, to September 1, 2002. Each groups were consisted with 10 patients. Each patient chart was examined and blood sample parameters were reviewed with clinical signs, symptoms and vital sign at preoperative day, postoperative 1 day, postoperative 1 week. Several parameters were analyzed statistically for extraction of mean values and differences between the periods groups. The findings of serum parameters of cancer, abscess and fracture groups were as follows: 1. In cancer patients, Hb, MCV, albumin, cholesterol, LDH, AST, ALT, neutrophil, platelet, leukocyte, Na, K, Cl, BUN, creatinine were analyzed. Values of Hb, albumin, AST, neutrophil, leukocyte, Cl showed significantly differences according to periods. 2. In abscess patients, CRP, ESR, leukocyte, body temperature, neutrophil were analyzed. Values of CRP, leukocyte, body temperature, neutrophil showed significanlty differences according to periods. 3. In fracture patients, same arameters with cancer patient's were chosen. Values of platelet, Cl only showed significantly differences according to periods. 4. In cancer patients, data regarding correlation was analyzed statistically as Pearson's value. A positive correlation was found between Hb and albumin, K, Na(p<0.05). A positive correlation was also found between neutrophil and leukocyte(p<0.05). Positive correlations were found between cholesterol and ALT, LDH and platelet, creatinine both, Platelet and BUN, Na and K(p<0.01). 5. In abscess patients, Peason's correlation values were analyzed on parameters. A positive correlation was found only between CRP and neutrophil(p<0.05). 6. In fracture patients, The correlations of parameters also were statistically analyzed. Positive correlations were found between MCV and K, albumin and LDH, AST and three parameters of creatinine, Na, Cl, K and neutrophil, neutrophil and three parameters of leukocyte, BUN, K(p<0.05). Positive correlations were found between LDH and AST, ALT and AST, creatinine both(p<0.01). This retrospective clinical study showed the CRP levels only on abscess patients may be useful in determination of clinical infected status, but the levels of other parameters on cancer, fracture patients did not showed significant values as diagnostic aids for clinical status.
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Humans , Abscess , Blood Platelets , Body Temperature , Cholesterol , Creatinine , Facial Bones , Leukocytes , Mouth Neoplasms , Neutrophils , Nutritional Status , Retrospective Studies , Surgery, Oral , Vital SignsABSTRACT
BACKGROUND: We intended to investigate the relationship between red cell size observed through a light microscope and mean corpuscular volume (MCV) measured by an automatic hematology analyzer. METHODS: 164 samples which were referred for complete blood count analysis and peripheral blood cell morphology were selected. MCV was measured by Gen-S (Coulter Co., USA). Smear slides of the same samples were examined on a microscope with a CCD camera connected to it. The image observed through the microscope emerged on an IBM-compatible computer system through the CCD camera. Mean red cell size-mean corpuscular area (MCA) of the captured image was calculated by Image-Pro Plus, the image capture and analyzing software. RESULTS: The coefficient of variation (CV) of MCA measurement, which was done 5 times on 10 slides, was 1.5-3.6%. Compared to the measurements performed in the ideal zone, MCA was measured lower in the thickly smeared zone (medial zone) and higher in the thinly smeared zone (lateral zone) on smear slide observation. The correlation between MCA and MCV values was poor (R=0.641, P<0.01). The normal reference range of MCA measurement was 37.40-50.22 m2. CONCLUSIONS: As the red cell size observed on the light microscope does not correlate well with the MCV measured by automatic analyzer, the determination of red cell size by microscopic peripheral blood smear requires profound caution.
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Blood Cell Count , Blood Cells , Cell Size , Computer Systems , Erythrocyte Indices , Hematology , Reference ValuesABSTRACT
PURPOSE: The purpose of this study was to assess the usefulness of mean corpuscular volume (MCV), red cell distribution width (RDW) and hemoglobin distribution width (HDW), which can be measured easily with automatic blood cell counter, in differentiating anemia of acute infection from iron deficiency anemia (IDA) in the early phase of infection. We also wanted to determine whether decreased erythropoietin (EPO) production contribute to the pathogenesis of anemia of acute infection. METHODS: 39 anemic children who were admitted to Kangbuk Samsung Hospital due to acute infectious disease between June 1997 and September 1998 were studied. We measured serum ferritin level by radioimmunoassay and divided the patients into two groups according to the serum ferritin level. The children with serum ferritin level above 30 ng/mL were included in anemia of infection group, and the children with serum ferritin level under 10 ng/mL were included in IDA group. Anemic children whose ferritin level were between 10 ng/mL and 30 ng/mL were excluded. We measured MCV, RDW and HDW by automatic blood cell counter and compared them between two groups. We also measured EPO concentration in anemia of acute infection group and compared with that of the control group. RESULTS: 1) Most common acute infectious disease accompanied by anemia of acute infection were acute gastroenteritis, acute pharyngitis, and pneumonia. 2) Complete blood count (CBC) revealed normocytic normochromia in anemia of acute infection and microcytic hypochromia in IDA. MCV of IDA group was significantly lower than that of anemia of acute infection group (65.2+/-8.7 fL vs 82.4+/-5.5 fL, P<0.005). RDW in IDA group was significantly higher than that of anemia of acute infection group (17.1+/-2.5% vs 15.0+/-1.0%, P<0.005). HDW in IDA group was significantly higher than that of anemia of acute infection group (3.2+/-0.5 g/dL vs 2.4+/-0.2 g/dL, P<0.005). 3) The mean EPO concentration in anemia of acute infection group was significantly higher than that of control group (27.1+/-14.5 mU/mL vs 18.4+/-8.7 mU/mL, P<0.05). CONCLUSION: 1) We concluded that MCV, RDW and HDW are effective parameters to differentiate anemia of acute infection from IDA. 2) Decreased EPO production may have less significant role in the pathogenesis of anemia of acute infection compared to anemia of chronic disease. 3) Our results suggested that other factors such as accelerated erythrocyte destruction or hypoferremia may contribute to the development of anemia of acute infection. Further studies will be required to identify the pathophysiology of anemia of acute infection.
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Child , Humans , Anemia , Anemia, Iron-Deficiency , Blood Cell Count , Chronic Disease , Communicable Diseases , Erythrocyte Indices , Erythrocytes , Erythropoietin , Ferritins , Gastroenteritis , Pharyngitis , Pneumonia , RadioimmunoassayABSTRACT
0 1). (4)75 2% of all the patients in DM group showed one or more abnormalities in MCV or F wave parameters, and electrophysiological abnormalitis correlated with, or precede to clinical findings in 175 of 190 patients (92 1%). Conclusion MCV and F wave parameters are sensitive measures for detection of DPN. Among these parameters, FwPL, F MIPL from all the four nerves are the most sensitive. To improve diagnostic accuracy, all the MCV and F wave parameters recorded should be considered.