ABSTRACT
Introduction: Sepsis in elderly patients is a critical clinicalissue due to high rates of morbidity and mortality. The modernage cell counters precisely measure volume, size and internalstructure of the cell thereby assessing increase in volumeand cytoplasmic granularity of leukocytes as seen in casesof sepsis. The present study was done to evaluate the useof Volume Conductivity Scatter (VCS) parameters as earlyindicators of sepsis in elderly patients and to overcome theshortcomings of blood culture by using a more precise VCStechnology to assess morphologic changes in cell populationsin sepsis.Material and Method: The study included 51 patients abovethe age of 50 years which were divided into 2 groups Group1, patients with localised infection (n= 39) and Group 2 withsystemic infection (n=12). Group 3 included 30 controlswithout any signs of infection and with total leucocyte countand differential counts within normal limits. Coulter LH 750cellular analysis system was used.Result: Significant increase in both mean neutrophil volume(MNV) and mean monocyte volume (MMV) was reportedamong the patients with sepsis as compared to localizedinfections or control. With a cut off of 145 and 170 for MNVand MMV respectively, a sensitivity of 96% and 91.4% wasobtained in predicting sepsis.Conclusion: Both MNV and MMV have the potential to beused as early indicators of acute bacterial infections.
ABSTRACT
Objective To observe the clinical value of neutrophil VCS parameters in the patients with zinc oxide toxicosis.Methods The peripheral blood samples from 120 patients with zinc oxide toxicosis,50 patients with bacteria infection and 60 healthy subjects were tested using Coulter LH 750 hematology analyzer.VCS parameters,including mean neutrophil volume (MNV),neutrophil distribution width (NDW),mean neutrophil conductivity (MNC) and mean neutrophil scattering value (MNS),were examined before and after treatment.Results MNV in patients with zinc oxide toxicosis increased significantly compared with those of healthy group and bacterial-infectious group.On the contrary,MNC decreased significantly in the patients with zinc oxide toxicosis compared with that of healthy group and bacterial infection patients.There was significant statistical difference between the two groups (P ＜ 0.01).When the cut-off value is less than 144.70,the sensitivity and specificity of differential diagnosis are 90.83％,98.33％,respectively,higher than those of WBC count and other VCS parameters.The values of MNC in WBC greater than or equal to 10.0 × 109/L group and WBC less than 10.0 × 109/L group were (140.05 ±4.26) and (138.87 ±5.87) respectively.There was no significant difference between the two groups (P ＞ 0.05).The values returned to normal range after treatment for 3 days.Conclusion The MNC of neutrophil may reflect the morphologic change of neutrophils in zinc oxide toxicosis and restore its normal value after treatment,so it can be used as a marker for diagnosis and monitoring of disease.
ABSTRACT
The coexistence of chronic myeloid leukaemia(CML) and chronic lymphocytic leukemia(CLL) has been reported occasionally in literature, with only seven cases of simultaneous occurrence of these two diseases. We present here a case of 57 yr male patient where a complete blood count and differential done using volume conductivity scatter (VCS) technology suggested a diagnosis of CML with CLL. It was further confi rmed by immunophneotyping and cytogenetic analysis. The patient was started on tyrosine kinase inhibitor, 400 mg once daily. Four months after the treatment, patient is doing fi ne with a count of 22 × 109/L and 64% lymphocytes.