Schistocytes Evaluation in Iron Deficiency: An Assessment Adopted From ICSH Nomenclature Guideline

Objective The diagnostic validity of schistocyte count in diagnosing iron deficiency in the microcytic population is critical to evaluate. The purpose of this study is to identify the correlation between schistocyte count and iron parameters, and the performance of schistocyte count in diagnosing iron deficiency in the microcytic population.Results Out of 805 general check-up participants, 65 subjects consisting of 17 males and 48 females aged 18–56 years had Mean Corpuscular Value (MCV) < 80 fL. Serum ferritin examination showed 25 patients with iron deficiency and the other 40 subjects without iron deficiency. There was a significant difference in the schistocyte count between the two groups (p < 0,001). Correlation analysis obtained a significant relationship between schistocyte count and serum ferritin (r=-0,67, p < 0,001). The Receiver Operating Characteristic (ROC) curve analysis provided Area Under the Curve (AUC) of schistocyte count is 0.827 with Youden Index (YI) 55% for a cut-off of ≥0.75%.

[1]  A. Ogbenna,et al.  Erythrocyte Morphology and Its Disorders , 2019, Erythrocyte.

[2]  E. Schapkaitz,et al.  Performance evaluation of the new measurement channels on the automated Sysmex XN-9000 hematology analyzer. , 2018, Clinical Biochemistry.

[3]  R. Pasquini,et al.  Evaluation of criteria of manual blood smear review following automated complete blood counts in a large university hospital , 2017, Revista brasileira de hematologia e hemoterapia.

[4]  W. Barcellini,et al.  Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia , 2015, Disease markers.

[5]  C Briggs,et al.  ICSH recommendations for the standardization of nomenclature and grading of peripheral blood cell morphological features , 2015, International journal of laboratory hematology.

[6]  B. T. Constantino,et al.  Reporting and grading of abnormal red blood cell morphology , 2015, International journal of laboratory hematology.

[7]  G. Alvarez-Uria,et al.  Prevalence and Severity of Anaemia Stratified by Age and Gender in Rural India , 2014, Anemia.

[8]  Ashutosh Kumar,et al.  An analytical study on peripheral blood smears in anemia and correlation with cell counter generated red cell parameters , 2013 .

[9]  E. Urrechaga.  Discriminant value of % microcytic/% hypochromic ratio in the differential diagnosis of microcytic anemia , 2008, Clinical chemistry and laboratory medicine.

[10]  A. Harrington,et al.  Iron deficiency anemia, beta-thalassemia minor, and anemia of chronic disease: a morphologic reappraisal. , 2008, American journal of clinical pathology.

[11]  J. Ben-Ezra.  Clinical Characteristics of Patients with a RBC Fragment Flag on the Advia® 2120 Automated Hematology Analyzer. , 2007 .

[12]  C. Brugnara.  A hematologic "gold standard" for iron-deficient states? , 2002, Clinical chemistry.

[13]  J. Mansbridge,et al.  Skin substitutes to enhance wound healing. , 1998, Expert opinion on investigational drugs.

[14]  L. Szarpak,et al.  The assessment of the utility of novel peripheral blood morphology parameters, including reticulocytic, in the diagnosis of iron deficiency and sideropenic anemia , 2018 .

[15]  J. Fish,et al.  Lanzkowsky's Manual of Pediatric Hematology and Oncology , 2016 .