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Journal of Clinical Pathology Mar 2023Recently, a new automated digital cell imaging analyser (Sysmex CellaVision DC-1), intended for use in low-volume and small satellite laboratories, has become available....
AIMS
Recently, a new automated digital cell imaging analyser (Sysmex CellaVision DC-1), intended for use in low-volume and small satellite laboratories, has become available. The purpose of this study was to compare the performance of the DC-1 with the Sysmex DI-60 system and the gold standard, manual microscopy.
METHODS
White blood cell (WBC) differential counts in 100 normal and 100 abnormal peripheral blood smears were compared between the DC-1, the DI-60 and manual microscopy to establish accuracy, within-run imprecision, clinical sensitivity and specificity. Moreover, the agreement between precharacterisation and postcharacterisation of red blood cell (RBC) morphological abnormalities was determined for the DC-1.
RESULTS
WBC preclassification and postclassification results of the DC-1 showed good correlation compared with DI-60 results and manual microscopy. In addition, the within-run SD of the DC-1 was below 1 for all five major WBC classes, indicating good reproducibility. Clinical sensitivity and specificity were, respectively, 96.7%/95.9% compared with the DI-60% and 96.6%/95.3% compared with manual microscopy. The overall agreement on RBC morphology between the precharacterisation and postcharacterisation results ranged from 49% (poikilocytosis) to 100% (hypochromasia, microcytosis and macrocytosis).
CONCLUSIONS
The DC-1 has proven to be an accurate digital cell imaging system for differential counting and morphological classification of WBCs and RBCs in peripheral blood smears. It is a compact and easily operated instrument that can offer low-volume and small satellite laboratories the possibilities of readily available blood cell analysis that can be stored and retrieved for consultation with remote locations.
Topics: Humans; Reproducibility of Results; Blood Cells; Leukocyte Count; Leukocytes; Hematologic Tests; Blood Cell Count
PubMed: 34620610
DOI: 10.1136/jclinpath-2021-207863 -
Transfusion Jan 2024Hereditary pyropoikilocytosis (HPP) is a heterogeneous inherited disorder of red blood cell (RBC) membrane and cytoskeletal proteins that leads to hemolytic anemia. HPP...
INTRODUCTION
Hereditary pyropoikilocytosis (HPP) is a heterogeneous inherited disorder of red blood cell (RBC) membrane and cytoskeletal proteins that leads to hemolytic anemia. HPP is characterized by marked poikilocytosis, microspherocytes, RBC fragmentation, and elliptocytes on peripheral blood smear. Mutations in SPTA1 can cause HPP due to a quantitative defect in α-spectrin and can lead to profound fetal anemia and nonimmune hydrops fetalis, which can be managed with intrauterine transfusion.
CASE PRESENTATION
We present a case of a 26-year-old G4P2102 woman of Amish-Mennonite ancestry with a pregnancy complicated by fetal homozygosity for an SPTA1 gene variant (SPTA1c.6154delG) as well as severe fetal anemia and hydrops fetalis, which was managed with four intrauterine transfusions between 26 and 30 weeks gestation. Pre-transfusion peripheral smears from fetal blood samples showed RBC morphology consistent with HPP. The neonate had severe hyperbilirubinemia at birth, which has resolved, but remains transfusion-dependent at 6 months of life.
DISCUSSION/CONCLUSION
To our knowledge, this is the first report that correlates homozygosity of the SPTA1c.6154delG gene variant with RBC dysmorphology and establishes the diagnosis of HPP.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Adult; Hydrops Fetalis; Elliptocytosis, Hereditary; Cytoskeletal Proteins; Anemia, Hemolytic; Fetal Diseases; Hematologic Diseases
PubMed: 38031483
DOI: 10.1111/trf.17617 -
Environmental Science and Pollution... Feb 2023The use of plant growth regulators has led to environmental contamination of water bodies that occur adjacent to agricultural areas. Some of these chemicals are...
The use of plant growth regulators has led to environmental contamination of water bodies that occur adjacent to agricultural areas. Some of these chemicals are bioactive, not only to plants, but also to non-target exposed biota, namely of the aquatic compartment. Previous work demonstrated the establishment of hepato- and nephrotoxic effects in juvenile tilapia (Oreochromis niloticus) exposed via aquatic media to gibberellic acid (GA), which is among the most used plant growth regulators, in agricultural practices. Here, we investigated the effect of GA on hematological indices, poikilocytosis, nuclear abnormalities, and genotoxic indices measured in Nile tilapia (Oreochromis niloticus), as well as the putative protective effects of dietary supplementation of Spirulina (Arthrospira platensis). Fish were evenly assorted into 5 groups: group I served as a control, and groups II-V were fed diets supplemented with Spirulina at rates of 0 g/kg, 5 g/kg, 20 g/kg, and 100 g/kg, respectively, for 2 months before being exposed to 150 mg/L GA. The results revealed that GA exposure decreased significantly all hematological indices (P < 0.05), except leucocytes and mean corpuscular hemoglobin concentration (MCHC), compared to the control group (P > 0.05). GA exposure increased significantly the percentage of nuclear abnormalities, altered erythrocytes and the percentages of tail DNA, compared to the control group (P < 0.05). Spirulina supplementation restored the hematological, poikilocytosis, nuclear abnormalities, and the percentages of tail DNA to near normal levels. The 100 g/kg SP treatment was the most effective in attaining such effect, showing concentration-dependency. The present study reinforces our findings of the toxicity of GA on O. niloticus and suggests that the addition of Spirulina to fish diet can mitigate the hemotoxic effects of GA.
Topics: Animals; Cichlids; Tilapia; Spirulina; Plant Growth Regulators; Dietary Supplements; Diet; Animal Feed
PubMed: 36346524
DOI: 10.1007/s11356-022-23844-6 -
The Science of the Total Environment Dec 2022Increases in human population lead to an increase in urban wastes, which could affect wildlife in several ways. Urban pollutants can affect erythrocytes of birds...
Increases in human population lead to an increase in urban wastes, which could affect wildlife in several ways. Urban pollutants can affect erythrocytes of birds generating morphological membrane and nuclear anomalies. The Kelp Gull (Larus dominicanus) is an opportunistic species, which take advantage of urban environments, thus being highly exposed to environmental pollution. In northeastern Patagonia, the dynamic of the waste management was transformed in the last decade and consequently, gulls changed their movements in response to changes in waste management systems. The food available to the seagulls went from being a mixture of urban/fishing discards until 2015, when this landfill closures, to being domestic urban offerings. In order of evaluating genotoxicity and changes in pollutants exposition due to these changes, we analyzed the frequencies of erythrocytes nuclear abnormalities and micronuclei (ENAs and MN respectively) in 58 blood smears from adults extracted during the non-breeding season in two periods in landfills with different waste compositions: a mixed landfill (ML) in 2013 before closure (n = 24) versus an urban landfill (UL) (n = 34) in 2021. We found that the Kelp Gull showed high values of abnormalities with an average of 151.5 /10,000 RBC in comparison with other seabird species. The bud and notched types of ENAs were the most prevalent abnormalities in both sites. We did not find significate differences in the overall abnormality frequency between sites, however we found significant higher frequencies in displaced and tailed types of ENAs in ML. We also found poikilocytosis, as seen previously in other animals exposed experimentally to pollutants such as metals and crude oil. Cellular abnormalities found in the Kelp Gull suggest an exposition of individuals to pollutants in foraging areas. The hemispheric distribution and the synanthropic characteristics of the species denote its importance as a suitable global monitor of genotoxicity.
Topics: Animals; Birds; Charadriiformes; Environmental Pollutants; Humans; Kelp; Petroleum
PubMed: 35964745
DOI: 10.1016/j.scitotenv.2022.157958 -
Annals of Medicine and Surgery (2012) Dec 2022Secondary thrombocytosis, also known as reactive thrombocytosis, is defined as an abnormal increase in platelet count as a result of another underlying medical or...
INTRODUCTION
Secondary thrombocytosis, also known as reactive thrombocytosis, is defined as an abnormal increase in platelet count as a result of another underlying medical or surgical condition. Once the medical cause of reactive thrombocytosis was determined, it could be treated. In this case, supportive treatment with no iron supplements for anemia and infection improved the case condition rapidly.
CASE PRESENTATION
we report a 20 years old Sudanese female who presented with high-grade fever, right iliac fossa pain, hyper pigmented macules on the tongue and a past history of undiagnosed anemia. Laboratory results showed platelets = 1007 × 10^3/μl, hemoglobin = 3.5 g/dl with low MCV, total WBC was also high = 14.9 × 10^3/μl. Peripheral blood picture showed anisocytosis and poikilocytosis, microcytic hypochromic RBCs associated with target cells, pencil cells, teardrops cells and polychromies cells and with leukocytosis and very high platelets in the film. Abdominal ultrasound showed evidence of pelvic inflammatory disease. After receiving supportive treatment, antibiotics and 3 units of blood the patient showed remarkable improvement and reduction in platelet count.
DISCUSSION
We discuss the mechanism of the reactive thrombocytosis state and the variable treatment options when accompanied with iron deficiency anemia.
CONCLUSION
Reactive thrombocytosis with extreme platelet count should always be considered in patients presented with severe iron deficiency anemia and infection. In this case report the high platelet count was reversed successfully after commencing antibiotics and blood transfusion although of the poor patient compliance and the poor investigations were obtained from the patient.
PubMed: 36582913
DOI: 10.1016/j.amsu.2022.104927 -
Veterinary Clinical Pathology Mar 2015Anemia and systemic oxidative stress may occur in dogs with chronic kidney disease (CKD). Only scarce information regarding the intraerythrocytic redox status under...
BACKGROUND
Anemia and systemic oxidative stress may occur in dogs with chronic kidney disease (CKD). Only scarce information regarding the intraerythrocytic redox status under these conditions is available at this time.
OBJECTIVE
The aim of this study was to evaluate the indicators of oxidative stress and intraerythrocytic antioxidant defense in dogs with anemia of CKD.
METHODS
Thirty dogs with CKD in stages 3 or 4 with nonregenerative anemia (HCT ≤ 37%) were compared to 20 healthy dogs. Complete blood count, reticulocyte %, blood smear evaluation, intraerythrocytic concentrations of total (GSHt), reduced (GSH), and oxidized glutathione (GSSH), and activities of glutathione peroxidase, glutathione reductase and superoxide dismutase (SOD), as well as plasma concentrations of thiobarbituric acid-reactive substances (TBAR) were determined.
RESULTS
Anemia of CKD dogs was nonregenerative (reticulocytes ≤ 0.2% with scarce anisocytosis and poikilocytosis). Intraerythrocytic GSSH and SOD, and plasma TBAR were higher in dogs with CKD. There was a positive correlation between the creatinine concentration and TBAR, and negative correlations between creatinine concentration and HCT, as well as between HCT and TBAR. In CKD dogs with a higher degree of anemia, SOD levels were higher and GSSH concentrations were lower. Despite the evidence of increased systemic oxidative stress, the compensatory response of SOD and the sustained intraerythrocytic concentrations of GSSH in CKD dogs with anemia indicated that the erythrocytes maintained the antioxidant defense.
CONCLUSIONS
There was no strong evidence that oxidative stress was associated with higher degrees of anemia in dogs with CKD.
Topics: Anemia; Animals; Antioxidants; Dogs; Erythrocytes; Female; Glutathione Peroxidase; Glutathione Reductase; Male; Oxidative Stress; Renal Insufficiency, Chronic; Superoxide Dismutase; Thiobarbituric Acid Reactive Substances
PubMed: 25512201
DOI: 10.1111/vcp.12225 -
Environmental Science and Pollution... Jun 2021Copper has toxic effects in fish, whereas the cyanobacterium Spirulina reportedly has protective effects against metal toxicity in various animal species. The current...
Investigating the effects of copper sulfate and copper oxide nanoparticles in Nile tilapia (Oreochromis niloticus) using multiple biomarkers: the prophylactic role of Spirulina.
Copper has toxic effects in fish, whereas the cyanobacterium Spirulina reportedly has protective effects against metal toxicity in various animal species. The current study, therefore, aimed to investigate the prophylactic role of Spirulina platensis against the effects of copper sulfate (CuSO) and copper oxide nanoparticles (CuO-NPs) in Nile tilapia (Oreochromis niloticus). Biochemical, antioxidant, erthyron profile and histopathological endpoints were assessed after for 15 days of exposure in five separate treatment groups: (1) fish pre-fed the normal diet (control), (2) fish pre-fed the normal diet and exposed to 15 mg/L of CuSO, (3) fish pre-fed the normal diet augmented with 0.25% Spirulina and exposed to 15 mg/L of CuSO, (4) fish pre-fed the normal diet and exposed to 15 mg/L of CuO-NPs, and (5) fish pre-fed the normal diet augmented with 0.25% Spirulina and exposed to 15 mg/L CuO-NPs. Exposure to CuSO or CuO-NPs significantly increased superoxide dismutase and catalase activities in fish, as well as serum total protein, glucose, aspartate aminotransferase, alanine aminotransferase, creatinine, and uric acid concentrations. In contrast, most hematological indices in fish significantly decreased after CuSO or CuO-NPs exposure. Moreover, CuSO and CuO-NPs caused a significant increase in the percentage of poikilocytosis and nuclear abnormalities of red blood cells, as well as histopathological changes in the brain, liver, intestine, and kidneys. Importantly, Spirulina supplementation mitigated against physiological disruption caused by CuSO or CuO-NPs.
Topics: Animals; Biomarkers; Cichlids; Copper; Copper Sulfate; Nanoparticles; Oxides; Spirulina
PubMed: 33580857
DOI: 10.1007/s11356-021-12859-0 -
Journal of Clinical Pathology Jul 2023Krüppel-like factor 1 (KLF1) is an erythroid-specific transcription factor playing an important role in erythropoiesis and haemoglobin (Hb) switching. Biallelic KLF1...
AIMS
Krüppel-like factor 1 (KLF1) is an erythroid-specific transcription factor playing an important role in erythropoiesis and haemoglobin (Hb) switching. Biallelic KLF1 mutations can cause haemolytic anaemia with thalassaemia-like syndromes but are rarely reported. We explore the KLF1 mutations in Thai subjects with unexplainable haemolytic anaemia.
METHODS
The study was done on 57 subjects presented with haemolytic anaemia and elevated Hb F without β-thalassaemia diseases. Hb analysis was performed using capillary electrophoresis. Analyses of α-thalassaemia, β-thalassaemia and KLF1 genes were performed using PCR-based methods and DNA sequencing.
RESULTS
Thirteen subjects with compound heterozygous for a known and five new genetic KLF1 interactions were identified, including KLF1:c.519_525dupCGGCGCC/c.892G>C with class 3/2 (n=8), and each subject with new genetic interaction, including KLF1:c.-154C>T;643C>T/c.983G>A with class 3/2, KLF1:c.-154C>T;643C>T/c.809C>G with class 3/2, KLF1:c892G>C/c.983G>A with class 2/2, KLF1:c.892G>C/c.1001C>G with class 2/2 and KLF1:c.1001C>G/c.1003G>A with class 2/2. Most of them had anaemia with Hb levels ranging from 45 to 110 g/L, hypochromic microcytosis, aniso-poikilocytosis, increased Hb F levels (17.9%-47.4%), small amounts of Hb Bart's, regular blood transfusion, hyperbilirubinaemia, increased serum ferritin and nucleated red blood cell.
CONCLUSIONS
Biallelic KLF1 mutations associated with anaemia may not be uncommon in Thailand. Characteristics of haemolytic anaemia, abnormal red cell morphology with nucleated red blood cells and elevated Hb F, and presenting small amounts of Hb Bart's without thalassaemia diseases are useful markers to further investigation of the KLF1 gene.
PubMed: 37507221
DOI: 10.1136/jcp-2023-208945 -
American Journal of Veterinary Research Dec 2021To document RBC abnormalities in dogs with congenital ventricular outflow tract obstruction.
OBJECTIVE
To document RBC abnormalities in dogs with congenital ventricular outflow tract obstruction.
ANIMALS
62 dogs with pulmonic stenosis (PS) or aortic stenosis (AS) and 20 control dogs were recruited.
PROCEDURES
The proportions of RBCs that were schistocytes, acanthocytes, and keratocytes were assessed. Complete blood cell counts were performed. Tested variables included hemoglobin concentration, hematocrit, and erythrocyte count.
RESULTS
Median (interquartile range [IQR]) peak systolic Doppler-derived trans-stenotic pressure gradient (∆P) values were 161 mm Hg (108 to 215 mm Hg) and 134 mm Hg (125 to 165 mm Hg) for dogs with PS and AS, respectively. Hematologic abnormalities were detected in most dogs with AS or PS (54/62 [87%]) versus 8/20 [40%] in control dogs, with schistocytes found in 40 of 62 (65%; median, 0.1% RBCs; IQR, 0% to 0.3%), acanthocytes in 29 of 62 (47%; median, 0.3% RBCs; IQR, 0% to 0.9%), keratocytes in 39 of 62 (63%; median, 0% RBCs; IQR, 0% to 0.2%), and hemolytic anemia in 4 dogs with PS. No significant association was identified between these abnormalities and ∆P. However, 3 of 4 dogs with anemia had a ∆P > 200 mm Hg (range, 242 to 340 mm Hg). The dog with the highest ∆P value also had the most severe anemia and schistocytosis, and both resolved after balloon valvuloplasty.
CLINICAL RELEVANCE
Poikilocytosis is common in dogs with congenital ventricular outflow tract obstruction, with anemia only observed in few dogs with high ∆P values.
Topics: Animals; Dog Diseases; Dogs; Erythrocytes; Heart Ventricles; Pulmonary Valve Stenosis
PubMed: 34936577
DOI: 10.2460/ajvr.21.11.0188 -
Journal of Veterinary Research Jun 2020Although peripheral blood analysis has become increasingly automated, microscopy is the only available method for the diagnosis of anisocytosis and poikilocytosis. The...
INTRODUCTION
Although peripheral blood analysis has become increasingly automated, microscopy is the only available method for the diagnosis of anisocytosis and poikilocytosis. The aims of the study were to compare RBC volume data obtained with two different analysers and by manual assessment of smears and to compare this data between dogs in various stages of heart failure secondary to degenerative mitral valvular (DMV) disease. The impact of diuretic administration on RBC morphology was also assessed.
MATERIAL AND METHODS
Sixty-eight dogs, 56 in different stages of DMV disease and 12 as healthy controls, were studied. Impedance and flow cytometry haematological analyses were performed for each animal. Additionally, two smears were prepared for manual analysis. RBC structure, staining, and size differences were recorded.
RESULTS
There were no significant differences between the blood morphological parameters assessed using haematological analysers nor between dogs receiving diuretic treatment and those not treated. Based on the manual smear, significantly higher erythrocyte anisocytosis was observed in the dogs with symptomatic DMV disease than in the control group.
CONCLUSION
Haematological analysers based on impedance and flow cytometry provide reliable and comparable morphological results in dogs with heart failure. However, microscopic assessment of blood smears is a more reliable tool to detect erythrocyte anisocytosis.
PubMed: 32587922
DOI: 10.2478/jvetres-2020-0043