Analytical variability of estimated platelet counts on canine blood smears

Paltrinieri, Saverio; Paciletti, Veronica; Zambarbieri, Jari

doi:10.1111/vcp.12604

Cited by 9 publications

(4 citation statements)

References 17 publications

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“…Interobserver agreement was quite variable for manual counts, with CVs ranging from 0% to 106.1% (mean 27.3%), demonstrating that the variability of manual NRBC counts is high and operator‐dependent. Similar high interobserver variability has been reported for platelet estimates in dogs 30 …”

Section: Discussionsupporting

confidence: 84%

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Analytical errors in nucleated red blood cell enumeration

Brown

Oscos-Snowball

Courtman

2023

Veterinary Clinical Pathol

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BackgroundEnumeration of nucleated red blood cells (NRBCs) in peripheral blood of dogs and cats is performed by manual counting during blood film evaluation. Automated methods have increased precision and accuracy; however, most analyzers cannot distinguish leukocytes and NRBCs. The Sysmex XN‐V Series may distinguish NRBCs and leukocytes; however, analytical errors occur.ObjectivesWe aimed to investigate cases with discrepant automated and manual NRBC counts, and to evaluate reasons for analytical errors.MethodsData from samples with increased NRBCs were collected retrospectively and compared with manual counts performed on blood films using Spearman's correlation, Passing‐Bablok agreement analysis, and Bland–Altman comparisons. Precision of the automated method and interobserver agreement of manual counts were evaluated. Cases with discrepant results were investigated.ResultsAgreement between the methods was good at ≤1NRBC ×109/L in dogs and cats, and inadequate at ≥1NRBC ×109/L. The automated method demonstrated a negative proportional difference to the manual method. Precision was good for the automated method (overall CV 7.1%) and interobserver agreement for the manual method was poor overall (mean CV 27.3%, range 0%‐106.1%). Inaccuracies in NRBC enumeration by the automated method occurred with high hematocrits, the mergence of the cell fragments and leukocyte clouds, and the presence of earlier erythroid precursors.ConclusionsNRBC enumeration by the WNR channel on the Sysmex XN‐1000 V is precise and has good agreement with manual counts in canine and feline blood samples at ≤1NRBC ×109/L. Manual film review is indicated for samples with ≥1NRBC ×109/L, earlier erythroid precursors, samples from greyhounds and dehydrated patients, and if gating errors are noted.

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Section: Discussionsupporting

confidence: 84%

“…Similar high interobserver variability has been reported for platelet estimates in dogs. 30 Overall, the agreement between the two methods varies based on the NRBC count. Evaluation of the Bland-Altman graphs reveals that agreement is better at lower NRBC counts, demonstrated by the low bias and relatively narrow LoAs.…”

Section: Discussionmentioning

confidence: 99%

Analytical errors in nucleated red blood cell enumeration

Brown

Oscos-Snowball

Courtman

2023

Veterinary Clinical Pathol

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“…The use of 10 microscope fields has a long tradition; for example, it has been used when counting platelets on a blood smear. [2][3][4] In medical hematology, the most recent consensus 5,6 calls for evaluating a minimum of 1000 erythrocytes (RBCs) to provide a precise percentage of the cells having a particular morphological abnormality. An adaption of this has also been reported in veterinary hematology 7 when counting the number of polychromatophilic cells, first to count the number of erythrocytes in two high-power fields (HPF) within the monolayer region and then averaging the counts to estimate the number of RBCs/ HPF for each blood film.…”

Section: Detection Of Spherocytosis In Dogs With Immune-mediated Hemo...mentioning

confidence: 99%

Detection of spherocytosis in dogs with immune‐mediated hemolytic anemia

Jensen

Krogh

2023

Veterinary Clinical Pathol

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“…First described by Gowland et al in 1969 in a patient with a malignant non-Hodgkin's lymphoma [1], PTCP was rapidly identified as being in vitro phenomenon with many further observations in healthy subjects, without a significant bleeding phenotype. EDTAdependent PTCP has also been described in animals such as cats, minipigs, dogs, and horses [26][27][28][29][30].…”

Section: Mechanisms Prevalence and Risk Factors 31 Mechanismsmentioning

confidence: 99%

Pseudothrombocytopenia—A Review on Causes, Occurrence and Clinical Implications

Lardinois

Favresse

Châtelain

et al. 2021

JCM

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Pseudothrombocytopenia (PTCP), a relative common finding in clinical laboratories, can lead to diagnostic errors, overtreatment, and further (even invasive) unnecessary testing. Clinical consequences with potential life-threatening events (e.g., unnecessary platelet transfusion, inappropriate treatment including splenectomy or corticosteroids) are still observed when PTCP is not readily detected. The phenomenon is even more complex when occurring with different anticoagulants. In this review we present a case of multi-anticoagulant PTCP, where we studied different parameters including temperature, amikacin supplementation, measurement methods, and type of anticoagulant. Prevalence, clinical risk factors, pre-analytical and analytical factors, along with clinical implications, will be discussed. The detection of an anticoagulant-dependent PTCP does not necessarily imply the presence of specific disorders. Conversely, the incidence of PTCP seems higher in patients receiving low molecular weight heparin, during hospitalization, or in men aged 50 years or older. New analytical technologies, such as fluorescence or optical platelet counting, will be soon overturning traditional algorithms and represent valuable diagnostic aids. A practical laboratory approach, based on current knowledge of PTCP, is finally proposed for overcoming spuriously low platelet counts.

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Analytical variability of estimated platelet counts on canine blood smears

Abstract: Platelet estimates suffer from high variability that could lead to patient misclassification. Therefore, guidelines to standardize the platelet estimate are needed.

Cited by 9 publications

References 17 publications

Analytical errors in nucleated red blood cell enumeration

Analytical errors in nucleated red blood cell enumeration

Detection of spherocytosis in dogs with immune‐mediated hemolytic anemia

Pseudothrombocytopenia—A Review on Causes, Occurrence and Clinical Implications

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