Establishment of reference intervals for pediatric complete capillary blood counts: A multicenter study in Beijing

Abstract

Introduction Clinical reference intervals represent the normal range of clinical parameters for distinguishing healthy and sick individuals, and they show some variation among different populations. Many reference intervals are still lacking for the pediatric population in China. Thus, the aim of this study was to establish and validate pediatric reference intervals for capillary blood cell counts. Methods A total of 9942 children were enrolled from 10 medical institutions in Beijing, China, for capillary complete blood count (CCBC) values according to the EP28‐A3c guideline issued by the Clinical and Laboratory Standards Institute. Results Pediatric reference intervals for 17 CCBC parameters were established for children aged 6 months to 7 years. The red blood cell count and red blood cell distribution width were generally higher in males than in females, and the mean corpuscular hemoglobin and mean corpuscular volume were higher in females than in males. The red blood cell, hemoglobin, hematocrit, and neutrophil percentages increased while the percentage of lymphocytes decreased with age. The overall trends for each reference interval were relatively similar in different ethnic groups and regions in the world, but with variation in the upper and lower limits, which confirms the existence of racial and geographical differences. Further validation with 508 healthy subjects showed that the verified proportions were within 90.9%‐100% of the reference intervals. Conclusions This study offers local reference intervals for CCBC values for the pediatric population in Beijing, China, and thus provides basic criteria for the diagnosis, treatment, and health assessment of childhood diseases in China.

Establishment of pediatric reference intervals for complete blood count parameters in capillary blood in Beijing

“…Other white blood cell‐related parameters, such as MONO# and MONO, were also relatively stable from 3 months to 18 years. LYM#, LYM, EO#, and EO gradually declined with age, and NEUT# and NEUT gradually increased with age; these trends were consistent with previous reports 6,17,18 . Gender differences were also observed in white blood cell‐related parameters.…”

“…this trend was consistent with the study of Wang et al 7 Unlike most red blood cell-related parameters, MCV and MCH were higher in females than in males; a similar observation was also reported by with age; these trends were consistent with previous reports. 6,17,18 Gender differences were also observed in white blood cell-related parameters. The levels of WBC, MONO#, MONO, EO#, and EO before 10 years of age were higher in males than in females, and the differences in MONO#, MONO, EO#, and EO continued after 10 years.…”

“…Since limited evidence exists on the agreement of CBC RIs between venous and capillary blood, ignoring the source of the blood and applying venous blood RIs directly to capillary blood may lead to inaccurate clinical diagnosis. To the best of our knowledge, only one previous study has reported CBC RIs based on capillary blood in subjects aged 6 months‐7 years 18 . The present study had a broader age span, ranging from 3 months to 18 years, such that school‐aged and adolescent children were included.…”

Reference intervals for erythrocyte parameters and hemoglobin electrophoresis parameters for young children in Guangxi

“…El‐Hazmi et al reported the difference of the RBC count, including RBC, Hb, MCV and MCH, between girls and boys did not show a significant change in the 1 to 13‐year‐olds 26 . Even though Sun et al and Wang et al reported the significantly difference of RBC, MCV and MCV between sex, except for Hb 11,12 . Obviously, the gender effect on the concentration of erythrocyte parameters should be explored on a larger sample size.…”

“…7,10 Laboratory results derived directly from reference intervals of adult can mislead clinical diagnosis and treatment, resulting in serious consequences. Although there have been preliminary studies on erythrocyte parameters for children in north China, 11,12 there is less information on erythrocyte and hemoglobin electrophoresis parameters for preschool children in Guangxi region of China. Therefore, establishing appropriate and accurate reference intervals of erythrocyte parameters and hemoglobin electrophoresis parameters, is of great significance for the prevention and treatment of hematological diseases and the accumulation of valuable genetic resources, and is also conducive to the screening of thalassemia in Guangxi.…”