Comparison of neutrophil volume distribution width to C-reactive protein and procalcitonin as a proposed new marker of acute infection

Abstract

NDW had the highest diagnostic accuracy and is available with the complete blood count with differential (CBC). It may be a promising parameter to aid in the diagnosis of acute infection in adults, provided the possibility of haematological disorders is first ruled out.

Biological Variations of Leukocyte Numerical and Morphologic Parameters Determined by UniCel DxH 800 Hematology Analyzer

“…We also evaluated the biological variations of leukocyte morphologic parameters or CPD, mainly because of an increasing number of publications [3][4][5][6][7][8][9][10][11][12][13] in recent years demonstrating the potential clinical utility of CPD in diagnosing many pathologic conditions, particularly in acute bacterial infection or sepsis. [3][4][5][6][7][8][9][10] We showed that the CPD have much smaller overall CV I and CV G compared to numerical parameters, suggesting that these morphologic parameters are less variable around the homeostatic set point intraindividually and interindividually. In addition, the index of individuality for all morphologic parameters was low.…”

“…[3][4][5][6][7] The mean neutrophil volume and/or neutrophil volume distribution width, which reflect respectively neutrophil size and size variations, show superior sensitivity and specificity for predicting sepsis compared to WBC, the percentage of neutrophils, band counts, C-reactive protein, or procalcitonin, proving to be promising indicators for the diagnosis of acute bacterial infection. 8,9 In addition, the mean neutrophil volume and neutrophil volume distribution width are significantly increased in postsurgical patients with bacterial infection compared with noninfected patients, although WBC was increased in both groups. 9,10 Alterations of the lymphocyte CPD in viral infection 11,12 and in chronic lymphocytic leukemia and other chronic lymphoproliferative disorders 12 as well as the monocyte CPD in malaria infection 13 have also been reported.…”

“…8,9 In addition, the mean neutrophil volume and neutrophil volume distribution width are significantly increased in postsurgical patients with bacterial infection compared with noninfected patients, although WBC was increased in both groups. 9,10 Alterations of the lymphocyte CPD in viral infection 11,12 and in chronic lymphocytic leukemia and other chronic lymphoproliferative disorders 12 as well as the monocyte CPD in malaria infection 13 have also been reported. Although several previous studies have investigated biological variations of numerical parameters of leukocytes [14][15][16][17] and demonstrated hour-to-hour and day-to-day intraindividual fluctuation of WBC, 17 this study is the first to investigate the biological variations of morphologic parameters of leukocytes because of their increasing clinical significance.…”

The Accuracy of Mean Neutrophil Volume Relative to Blood Culture for the Diagnosis of Sepsis: A Meta-analysis

“…2 Early diagnosis and appropriate management are critical to reducing mortality. 3 Early diagnosis may be more effective in overall cost containment and outcome than a more specific but late diagnosis. 4 Therefore, a rapid, accurate, and cost-effective test is needed.…”

“…4 Therefore, a rapid, accurate, and cost-effective test is needed. 3 However, early diagnosis of sepsis is difficult because the signs and symptoms of sepsis such as fever, are nonspecific and may be blunted or absent. 5 Peripheral blood smears can also yield important diagnostic information by identifying characteristic morphologic changes seen in reactive neutrophils.…”