Reference Intervals For Hematological Parameters Research Articles

Establishment of reference intervals for hematological parameters of adult population in the western region of Saudi Arabia.

Most of hematology laboratories in Saudi Arabia utilize the reference intervals (RIs) provided by instrument manufacturers. This study aimed to define RIs of hematological parameters for adult population in the western region of Saudi Arabia and to explore their specific features from an international perspective. This study was conducted according to the harmonized protocol of IFCC Committee on RIs and Decision Limits. Blood samples collected from 409 healthy Saudi males and females adults were analyzed for complete blood count (CBC) by using Cell-Dyn Sapphire analyzer and for iron profile by using Architect analyzers. The needs for RIs partitioned by sex and age was based on standard deviation ratio (SDR) and/or bias ratio (BR). RIs were derived parametrically with/without application of the latent abnormal values exclusion method (LAVE). Based on thresholds of SDR≥0.4 and/or BR≥0.57, RIs were partitioned by sex for red-blood cell count, hemoglobin, hematocrit, red cell distribution width, erythrocyte sedimentation rate, iron, transferrin, ferritin, eosinophil, platelet, plateletcrit, etc. Partitioning by age was not necessary for any of the analytes. LAVE procedure caused appreciable changes in RI limits for most erythrocyte and iron parameters but not for leukocyte parameters. Comparable to other non-IFCC studies on CBC RIs, the RBC and hematocrit (Ht) ranges have shifted to a higher side in both genders. After applying the LAVE method, the male and female RIs for Hb were 4.56 to 6.22 ×106/μL and 3.94 to 5.25 ×106/μL respectively while RIs for Ht were 40.2 to 52.0% and 33.6 to 44.5% respectively. LAVE method contributed to reducing the influence of latent anemia in deriving RIs for erythrocyte related parameters. Using the up-to-date methods, the RIs of CBC determined specifically for Saudis will help to improve the interpretation of test results in medical decision making.

Establishing pregnancy-specific haematological reference intervals in Ghana; a three-center cross-sectional study.

Abnormal intra-pregnancy haematological variables are associated with adverse feto-maternal outcomes. However, the reference intervals (RIs) employed in sub-Saharan Africa to inform clinical decisions are generally imported. Since RIs are influenced by age, geographical location, and race, we hypothesized that context specific RIs should be established in Ghana to contextualize intra-pregnancy decision making. This cross-sectional study retrospectively retrieved data of 333 pregnant women with no known clinically determined intra-pregnancy complications; 22 participants in their first trimester (T1; 1-13 weeks), 177 in their T2 (14-27 weeks), and 132 in T3 (28-41 weeks). RIs for haematological parameters were non-parametrically determined at 2.5th and 97.5th percentiles in accordance with CLSI guidance document EP28-A3c. Two-sample comparisons were undertaken using Wilcoxon rank-sum tests whereas more than two-sample comparisons were undertaken using Kruskal-Wallis test. Statistical significance was set at p <0.05 under the two-tailed assumptions. In accordance with WHO trimester-specific haemoglobin cutoffs, anaemia prevalence was a moderate (T1: 36.4%; 8/22 & T2: 31.6%; 56/177) to severe (T3:68.0%; 90/132) public health problem. Additionally, 9.3% (31/333) individuals had high gestational haemoglobin levels (Hb >13.0 g/dL). Moreover, haemoglobin (T2: 8.6-14.3 vs T3: 7.5-13.6 g/dL), MCH (T2: 22.5-69.8 vs T3: 21.6-31.9 pg), MCHC (T2: 30.2-51.8 g/L vs T3: 30.5-37.9 g/L), TWBC (T2: 4.0-13.4 vs T3: 4.1-13.0 x 109/L) required trimester specific RIs, compared to RBC (2.8-5.1 x 1012/L), MCV (66.2-100.2 fL), and platelet counts (106.3-388.3 x 109/L) that each required combined reference intervals. The intra-pregnancy haematological RIs determined have appreciable lower limits; there is the need to determine context-specific thresholds for haematological variables predictive of positive and/or adverse maternal and infant health outcomes.

Hematology reference intervals in 6–12-year-old children: the health-oriented pedagogical project (HOPP)

Reference intervals are essential for correct interpretation of laboratory test results, supporting clinicians in distinguishing between healthy and sick individuals. The present study aims to establish pediatric reference intervals for hematological parameters based on a large population of healthy schoolchildren. Blood samples were obtained from 1351 children 6–12 years of age participating in the Health-Oriented Pedagogical Project (HOPP). Reference intervals for hematological parameters were estimated by the nonparametric method following the CLSI C28-A3 guidelines. Reference intervals were estimated as 2.5th and 97.5th percentiles with corresponding 90% confidence intervals. While hematocrit and MCV required age and sex partitioning, hemoglobin and erythrocytes were partitioned for age. The remaining parameters, MCH, MCHC, platelets and white blood cell counts did not require partitioning. While red blood cell parameters exhibited an increasing trend with age, there was a slight decrease in leukocytes, lymphocytes, basophils and platelets with age. The remaining parameters were stable across our age span.

Indirect reference intervals for haematological parameters in capillary blood of pre-school children.

IntroductionIndirect estimation of reference intervals (RIs) is straightforward and inexpensive procedure for determination of intra-laboratory RIs. We applied the indirect approach to assess RIs for haematological parameters in capillary blood of pre-school children, using results stored in our laboratory database.Materials and methodsWe extracted data from laboratory information system, for the results obtained by automatic haematology analyser in capillary blood of 154 boys and 146 girls during pre-school medical examination. Data distribution was tested, and logarithmic transformation was applied if needed. Reference intervals were calculated by the nonparametric percentile method.ResultsReference intervals were calculated for: RBC count (4.2-5.4 x1012/L), haemoglobin (114-146 g/L), MCH (25.0-29.4 pg), MCHC (321-368 g/L), RDW-SD (36.1-43.5 fL), WBC count (4.5-12.3 x109/L), neutrophils count (1.7-6.9 x109/L) and percentage (29.0-69.0%), lymphocytes count (1.6-4.4 x109/L) and percentage (21.9-60.7%), PLT (165-459 x109/L), MPV (8.1-11.4 fL) and PDW (9.2-14.4%). Gender specific RIs were calculated for monocytes count (male (M): 0.2-1.6 x109/L; female (F): 0.1-1.4 x109/L) and percentage (M: 2.5-18.3%; F: 1.8-16.7%), haematocrit (M: 0.34-0.42 L/L; F: 0.34-0.43 L/L), MCV (M: 73.4-84.6 fL; F: 75.5-84.2 fL) and RDW (M: 12.1-14.3%; F: 11.7-13.9%), due to observed gender differences in these parameters (P = 0.031, 0.028, 0.020, 0.012 and 0.001; respectively). Estimated RIs markedly varied from the literature based RIs that are used in the laboratory.ConclusionsIndirect method employed in this study enables straightforward assessment of RIs in pre-school children. Herein derived RIs differed from the literature-based ones, indicating the need for intra-laboratory determination of RIs for specific populations and sample types.

Reference intervals for haematological parameters in the Lusitano horse breed.

The Lusitano horse is an autochthonous Portuguese breed with a growing worldwide expansion. Our objective was to establish reference intervals for haematological parameters using the haematological cell counter LaserCyte (IDEXX). For this purpose, blood samples from 100 healthy adult horses (13 females and 87 males, ranging from 3 to 25 years of age) were analysed. The reference intervals were estimated following the ASVCP guidelines with the Reference Value Advisor software. The obtained reference intervals were 6.4-10.1 × 1012/L for red blood cells, 30.6-45.1% for haematocrit, 11.6-17.1 g/dL for haemoglobin, 42.8-53.2 fL for mean corpuscular volume (MCV), 15.5-20.8 pg for mean corpuscular haemoglobin (MCH), 33.7-39.4 g/dL for mean corpuscular haemoglobin concentration, 17.8-20.3% for red cell distribution width (RDW), 4.5-10.1 × 109/L for white blood cells, 2.2-6.0 × 109/L for neutrophils, 0.9-4.9 × 109/L for lymphocytes, 0.2-0.5 × 109/L for monocytes, 0.1-0.6 × 109/L for eosinophils, 0.0-0.1 × 109/L for basophils, 78.5-172.2 K/mL for platelets, 4.3-9.4 fL for mean platelet volume, 18.8-24.2% for platelet distribution width, and 0.06-0.12% for plateletcrit. LaserCyte equine reference intervals are transferable to the Lusitano horse for 18 of the 22 analytes studied. Regarding age, significant statistical differences were observed for MCV, RDW, neutrophils and lymphocytes between the mean values of young (3-6 years old), middle-aged (7-14 years old) and old (< 15 years old) age groups. MCH means were statistically significantly different between the three age groups. The haematological reference intervals established in this study might represent a valuable and applicable tool for haematological assessment of adult Lusitano horses, providing useful information that helps clinicians to interpret clinical data.

Reference intervals for hematology test parameters from apparently healthy individuals in southwest Ethiopia.

Background:Clinical laboratory reference intervals are an important tool to identify abnormal laboratory test results. The generating of hematological parameters reference intervals for local population is very crucial to improve quality of health care, which otherwise may lead to unnecessary expenditure or denying care for the needy. There are no well-established reference intervals for hematological parameters in southwest Ethiopia.Objective:To generate hematological parameters reference intervals for apparently healthy individuals in southwest Ethiopia.Methods:A community-based cross-sectional study was conducted involving 883 individuals from March to May 2017. Four milliliter of blood sample was collected and transported to Jimma University Medical Center Laboratory for hematological analysis and screening tests. A hematological parameters were measured by Sysmex XS-500i hematology analyzer (Sysmex Corporation Kobe, Japan). The data were analyzed by SPSS version 20 statistical software. The non-parametric independent Kruskal–Wallis test and Wilcoxon rank-sum test (Mann–Whitney U test) were used to compare the parameters between age groups and genders. The 97.5 percentile and 2.5 percentile were the upper and lower reference limit for the population.Results:The reference interval of red blood cell, white blood cell, and platelet count in children were 4.99 × 1012/L (4.26–5.99 × 1012/L), 7.04 × 109/L (4.00–11.67 × 109/L), and 324.00 × 109/L (188.00–463.50 × 109/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in adults was 5.19 × 1012/L (4.08–6.33 × 1012/L), 6.35 × 109/L (3.28–11.22 × 109/L), and 282.00 × 109/L (172.50–415.25 × 109/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in geriatrics were 5.02 × 1012/L (4.21–5.87 × 1012/L), 6.21 × 109/L (3.33–10.03 × 109/L), and 265.50 × 109/L (165.53–418.80 × 109/L), respectively. Most of the hematological parameters showed significant differences across all age groups.Conclusion:Most of the hematological parameters in this study showed differences from similar studies done in the country. This study provided population-specific hematological reference interval for southwest Ethiopians. Reference intervals should also be established in the other regions of the country.

Reference values for selected hematological and serum biochemical parameters of Senegalese sole (Solea senegalensisKaup, 1858) juveniles under intensive aquaculture conditions

This work aims to establish normal reference intervals for selected hemato-biochemical parameters, based on their potential clinical relevance, and which may contribute to evaluating the health, nutritional and welfare status of Senegalese sole (Solea senegalensis Kaup, 1858) juveniles. Thirty-one healthy Senegalese sole juveniles grown under intensive aquaculture conditions were used in the study. Based on the robust method with Box–Cox transformation data the established reference intervals for hematological parameters were: hematocrit 12–26%, hemoglobin 2.8–6 g dl−1, erythrocytes 90–97.0% total, leucocytes 4–10% total; erythrocyte indices and differential leucocytes counts were also evaluated. Reference intervals for biochemical parameters were (g dl−1) glucose 19–86 mg dl−1, total protein 2.6–6.3, albumin 1–2.34, globulins 1.8–4.1, lipids 0.7–1.3, triglycerides 0.3–1.8, total cholesterol 0.1–0.9 g dl−1, HDL-cholesterol 4–65 mg dl−1, LDL-cholesterol 7–532 mg dl−1, sodium 124–202 mmol L−1), potassium 1.1–4.6 mmol L−1, calcium 7.6–13.2 mg L−1, magnesium 1.8–4.8 mg L−1, inorganic phosphorus 3.4–9.5 mg L−1, alkaline phosphatase 93–598 U L−1, aspartate aminotransferase 118–605 U L−1, lactate dehydrogenase 8.7–782 U L−1, and creatine phosphokinase 31.5–552 U L−1. This data is expected to provide a valuable tool to monitor the stress, health and nutritional conditions of Senegalese sole juveniles under aquaculture production.

The reference intervals for the haematological parameters in healthy adult population of chennai, southern India.

The haematological parameters are influenced by various factors like age, ethnicity, diet, genetic and gender differences and hence it is important to define the specific reference values with regards to the age, gender and the region. The indices like the Red Cell Distribution Width (RDW), the Mean Platelet Volume (MPV) and the Platelet Distribution Width (PDW) are newer haematological parameters which are calculated by automated haematology analyzers. There is an increasing evidence that these are clinically valuable bio markers. But not many studies have estimated the reference intervals for these parameters in our population. Our primary objective was to identify the gender specific reference intervals for RDW, MPV, PDW and other haematological parameters for the healthy adult population of our region. We also aimed at comparing the study reference intervals with the existing reference ranges. A retrospective review of 2443 medical case sheets of the individuals who attended the preventive health check up program in a tertiary care hospital in the year 2011, was done. With 500 subjects who satisfied our study criteria, the haematological reference intervals were established. Gender specific reference intervals were established for the newer indices as well as for the other haematological parameters. We derived the reference intervals for the newer parameters in our population as: RDW: 12.23%-15.36% in males and 12.3%-15.85% in females. MPV: 7.9 fL-13.7 fL in males and 8 fL -13.28 fL in females PDW: 9 fL -16.56 fL in males and 8 fL -13.28 fL in females. Our values differed from the existing haematological reference values, thus showing the importance of developing region-specific reference intervals. Our data also showed the importance of establishing gender specific reference intervals.

Hematology and Blood Biochemistry of Young Healthy Broad-Snouted Caimans (Caiman latirostris)

Caiman latirostris (Broad-Snouted Caiman) is widely distributed in wetlands and rivers of South America. Hematological and blood chemistry reference values are necessary for detecting the effects of environmental, infectious, parasitic, or toxicological stress on C. latirostris health. Peripheral blood samples were obtained from 24 healthy 6- to 18-month-old caimans. Blood cell dimensions and cytochemistry profiles were described; and reference intervals for hematological parameters, enzyme activities, and clinical analytes were established. Based on the caiman mass frequency distribution, two classes were distinguished: 125–900 g and 901–3,100 g. Although an overlap in age ranges was observed, total length and snout–vent length range values from both mass classes differed. This finding is particularly useful because, in the wild, caiman age is unknown, whereas growth parameters can be easily recorded. Caiman blood cells exhibited morphological features similar to those of other reptiles, with lymphocytes being the most numerous type of leukocytes. Significant positive correlations between mass and hemoglobin concentration, hematocrit, red blood cell, and white blood cell counts were observed. Neither sex nor age was associated with differences in these parameters. Analysis of blood chemistry values found in this study was done by comparing with values reported for related species. Both similarities and discrepancies with values from other crocodiles are discussed. This study provides baseline information from healthy juvenile caimans to which subsequent measurements can be compared. These data will aid in the medical management of caiman farms, zoo conservation programs, and field studies.

Long-term ethanol consumption and macrocytosis: diagnostic and pathogenic implications

Although excessive alcohol consumption is known to elevate the mean cell volume (MCV) of erythrocytes, the relationships among the intensity of ethanol exposure, the generation of abnormal red blood cell indices, and the underlying pathogenic mechanisms have remained unclear. The authors examined 105 alcoholics with a wide range of ethanol consumption (40-500 g of ethanol/day), 62 moderate drinkers (mean consumption 1-40 g/day), and 24 abstainers, who underwent detailed interviews, measurements of blood cell counts, markers of liver status, and circulating antibodies against ethanol-derived protein modifications. Follow-up information was collected from healthy volunteers with detailed records on drinking habits. Data from the NORIP project for laboratory parameters in apparently healthy moderate drinkers or abstainers (n = 845) were used for reference interval comparisons. The highest MCV (P < 0.001) and mean cell hemoglobin (MCH) (P < 0.01) occurred in the alcoholics. However, the values in the moderate drinkers also responded to ethanol intake such that the upper normal limit for MCV based on the data from moderate drinkers was 98 fl, as compared with 96 fl from abstainers. Follow-up cases with carefully registered drinking habits showed parallel changes in MCV and ethanol intake. Anti-adduct IgA and IgM against acetaldehyde-induced protein modifications were elevated in 94% and 64% of patients with high MCV, respectively, the former being significantly less frequent in the alcoholics with normal MCV (63%) (P < 0.05). The data indicate dose-related responses in red blood indices upon chronic ethanol consumption, which may also be reflected in reference intervals for hematological parameters in health care. Generation of immune responses against acetaldehyde-modified erythrocyte proteins may be associated with the appearance of such abnormalities.