Abnormal scattergrams and cell population data generated by fully automated hematological analyzers: New tools for screening malaria infection?

Buoro, Sabrina; Manenti, Barbara; Seghezzi, Michela; Moioli, Valentina; Bagorria, M; Callegaro, Annapaola; Ottomano, Cosimo; Lippi, Giuseppe

doi:10.1111/ijlh.12790

Cited by 18 publications

(24 citation statements)

References 19 publications

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“…We showed evidence that the pRBC flag from Sysmex XN-10 revealed a poor sensitivity of 7.8% for malaria parasites, notably for Pf samples (0/59). However, as previously demonstrated on the XN-10 analyser,2 3 the sensitivity was increased to nearly 50% if samples are positive for mature forms of Plasmodium that are mostly recovered during non-Pf infections. The sensitivity was also improved using a lower defined threshold of 10.…”

Section: Discussionmentioning

confidence: 53%

“…Automated complete blood count (CBC) is usually indicated for patients admitted with fever. Sysmex XN-10 was indeed reported to detect mature stages of Plasmodium through the flow cytometry White blood cells Differential Fluorescence (WDF) scattergram 2 3. Automated CBCs performed on Sysmex XN-10 haematology analyser (Sysmex Corporation, Kobe, Japan) may therefore represent a tool to suspect malaria diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Flagging performance of Sysmex XN-10 haematology analyser for malaria detection

et al. 2020

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AimThe aim was to assess the flagging performance of Sysmex XN-10 haematology analyser for malaria detection through the parasitic red blood cell (‘pRBC’) alarm.MethodsWe retrospectively studied 584 blood samples performed on the Sysmex XN-10 analyser that were tested for malaria. Sensitivity, specificity, positive and negative predictive values, and prevalence were established for the pRBC alarm.ResultsSensitivity, specificity, and positive and negative predictive values for the pRBC flag were 7.8%, 100%, 100% and 87.7%, respectively. The prevalence of pRBC flag of 0.026% in the overall population was significantly different from the prevalence of 1.027% in the population tested for malaria.ConclusionsConsidering the excellent specificity and the low prevalence of the flag in the overall population, we suggest, in case of the presence of pRBC flag, the implementation of a rapid review of the blood smear looking for Plasmodium, mostly if the patient had fever and had not been tested for malaria.

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Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Flagging performance of Sysmex XN-10 haematology analyser for malaria detection

et al. 2020

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“…To date, EDTA-dependent pseudothrombocytopenia is a relatively rare phenomenon, which has been known for nearly 40 years [10]. Other causes of spurious platelet count have been reported, mostly involving samples with presence of cellular debris [11], cryoglobulins [12], and bloodborne pathogens [13]. Sodium citrate-dependent pseudothrombocytopenia is instead a rather unusual, and hence less frequently appreciated, phenomenon in laboratory hematology, since a very limited number of cases have been described to date.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of sodium citrate-dependent artifactual platelet count

Dima

Salvagno

Danese

et al. 2020

IMAS

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Background Ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia is a rare phenomenon. Spurious pseudothrombocytopenia has also been described in other circumstances, while artifactual platelet count in whole blood samples anticoagulated with sodium citrate is an exceptional occurrence. Case report In this study, we describe the case of a 44-year-old ostensibly healthy woman who attended the local outpatient clinic for routine laboratory testing, including platelet count in EDTA and sodium citrate, for suspected artifactual pseudothrombocytopenia previously identified in another center. The results of hematological testing on both specimens were essentially normal, except for mild anemia. Nevertheless, the platelet number was 425 × 109/L in K2EDTA and 266 × 109/L (293 × 109/L after correcting for sample dilution) in sodium citrate, respectively. Microscopic revision of blood smears revealed the presence of platelet aggregates and satellitism only in the sodium citrate specimen. Conclusion Unlike previous occasional reports of concomitant EDTA- and sodium citrate-dependent pseudothrombocytopenia, we first describe a paradigmatic case of artifactual platelet count attributable to platelet clumping and satellitism, exclusively developing in blood anticoagulated with sodium citrate.

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“…This was possibly caused by the ability of P.falciparum to infect all the stages of the erythrocyte (reticulocyte and mature erythrocyte), while the other Plasmodium species only infect reticulocytes or immature erythrocytes. Mature erythrocytes that are infected by P.falciparum resemble the reticulocyte (pseudoreticulocyte), which is detected by Sysmex XN-1000 as a reticulocyte and included in 12,13 the RET calculation.…”

Section: Ret Scattergrammentioning

confidence: 99%

Correlation between WDF, WNR, and RET Abnormal Scattergram Detected by Sysmex XN-1000 and Parasitemia of Malaria Patients in Merauke Hospital

Ranoko¹,

Aryati²,

Hajat³

2019

Indonesian J. Clin. Pathol. Med. Lab.

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Malaria remains a health problem in Indonesia. Microscopic examination with Giemsa staining is the gold standard for diagnosing malaria. The density of parasites correlates with the degree of severity and response to therapy of malaria. Malaria-causing plasmodium can be detected by Sysmex XN-1000 which is marked by abnormalities in the WDF, WNR and RET scattergram. This research aimed to determine the correlation of WDF, WNR and RET abnormal scattergram detected by Sysmex XN-1000 and the parasitemia index of malaria at the Merauke General Hospital. This was a cross-sectional study with observational approach conducted between November 2017 – February 2018 at the Merauke General Hospital. Positive malaria samples were stained with Giemsa, their parasitemia index was calculated, routine complete blood count using Sysmex XN-1000 was performed, and the scattergram abnormalities were then analyzed. There were 65 positive malaria samples as follows: P.falciparum (35%), P.vivax (60%), P.ovale (3.1%), and P.malariae (1.5%), but the species did not correlate with parasitemic index (p=0.691). Abnormalities of WDF and WNR scattergram were predominantly found than RET scattergram (80% vs. 27.7%). P.vivax predominantly caused abnormalities of the WDF and WNR scattergram in 36 of 39 samples (92.3%), whereas P.falciparum predominantly caused abnomalities of the RET scattergram in 14 of 23 samples (60.9%). There was 95% positivity of an abnormality in WDF/WNR/RET scattergram with a cut-off of > 5,0165.5/µL. There was correlation between WDF, WNR, RET scattergram detected by Sysmex XN-1000 and the parasitemia index.

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Abnormal scattergrams and cell population data generated by fully automated hematological analyzers: New tools for screening malaria infection?

Cited by 18 publications

References 19 publications

Flagging performance of Sysmex XN-10 haematology analyser for malaria detection

Flagging performance of Sysmex XN-10 haematology analyser for malaria detection

An unusual case of sodium citrate-dependent artifactual platelet count

Correlation between WDF, WNR, and RET Abnormal Scattergram Detected by Sysmex XN-1000 and Parasitemia of Malaria Patients in Merauke Hospital

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