English

Abstract

Over the past few years complete blood count (CBC) by the automated hematology analyzers and microscopic examination of peripheral smear have complemented each other to provide a comprehensive report on patients' blood sample. Numerous classifications for anemia have been established and the important parameters involved in the classifications are Hb, HCT, MCV, RDW, MCH, MCHC, reticulocytes and IRF. Many of these values are obtained only by automated heamatology analyzers. One histogram graph is worth 1000 numbers. A large collection of data, displayed as a visual image, can convey information with far more impact than the numbers alone. In hematology, these data take on several forms, one of which is the RBC histogram. Therefore a study of variation in RBC histograms in various anemias. Many times it is seen that histogram patterns show varying features when a simultaneous peripheral smear is reported. It is also seen that there are many limitations when manual peripheral smears reporting is done for example: peripheral smear reports are subjective, labor intensive and statistically unreliable. However microscopic peripheral smear examination also has their advantages. This study intends to create a guide to laboratory personnel and clinicians with sufficient accuracy to presumptively diagnose morphological classes of anemia directly from the automated hematology cell counter forms and correlate with morphological features of peripheral smear examination. OBJECTIVE: 1. The objective of the study is to know the utility and advantage of red cell histograms. 2. To study the automated histogram patterns along with morphological features noticed on peripheral smear examination. SOURCE OF DATA: All anemic patients from Central Diagnostic Laboratory of A.J.IMS. METHOD OF COLLECTION OF DATA: A total of about 100 patients were included in the study. Complete blood count including HB, TC, DC, Platelet count hematocrit value, RBC indices was obtained from Heama - lab life D5 Supreme automated hematology analyzers. Peripheral smear examination was also obtained wherever necessary. RESULTS: This is a study of histogram of various types of anemia consisting of a total of 100 cases. All cases had anemia with hemoglobin less than 12gm/dl. All cases were studied with a correlation of peripheral smear findings. The cases consisted of Normocytic normochromic anemia, Microcytic hypochromic anemia, dimorphic anemia, Pancytopenia & Thalassemia, as diagnosed by peripheral smear. This study includes predominantly females (53%) more than males (47%).The age of patients ranged from 1day to 79 years. Maximum number of patients was in 30-40 years of age range. The anemic subjects had different types of anemia. Microcytic hypochromic anemia was the most common (61%), 17% of the cases are Normocytic normochromic anemia, 15%of cases with dimorphic anemia. Macrocytic anemia and Pancytopenia seen in 3% of the cases & thalassemia is seen in 1%. Representing the histogram variation in various anemias. Out of the 17% of normocytic normochromic anemia 8% showed normal histogram and 9% showed mild broad base curve histogram. Out of the 61% of microcytic hypochromic anemia, 4% were normal histogram, 27% were left shift histogram, 26% were broad base curve histogram, 2% short peak histogram and 2% abnormal (bimodal) histogram. Out of 3% of Macrocytic anemia 2% showed right shift with broad base curve histogram and 1% showed short peak histogram where hemoglobin was 5.3g/dl and RBCs