Modifications to the Manual Assessment of Platelet Counts from Peripheral Blood Smears- An Essential Correction Never Mentioned Before in Literature

Sudalaimuthu, Muthu; Rajendran, Koshalya; Ganapathy, Shivashekar

doi:10.21088/ijprp.2278.148x.6117.14

Cited by 1 publication

(9 citation statements)

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“…Field size is calculated by dividing the field number (written on the eyepiece) by objective magnification. Sudalaimuthu et al [3] also suggested a multiplication factor very close to our value for use in a microscope with field number 22. We further suggest that more studies should be done using different automated cell counters and microscope models to validate our findings.…”

Section: Discussionsupporting

confidence: 84%

“…Hence, in case of any flagging for platelet count by the automated cell counter, the value is cross-checked by alternate manual methods. The International Council for Standardization in Haematology (ICSH) and the International Society for Laboratory Hematology (ISLH) have recommended a method based on platelet/RBC ratio and fluorescent-labeled platelets as the reference method for platelet count estimation [1][2][3]. However, its high cost prevents its routine use in most laboratories.…”

Section: Discussionmentioning

confidence: 99%

“…The validity of this method was first established by Nosanchuk et al [4]. It is simple, reliable, cost-effective, and can be used in an emergency as well as in low-resource settings where automated analyzers are unavailable [1,3]. This method has the advantage of identifying platelet clumps/giant platelets/platelet satellitism or the presence of fragmented RBCs [3,[10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…It is simple, reliable, cost-effective, and can be used in an emergency as well as in low-resource settings where automated analyzers are unavailable [1,3]. This method has the advantage of identifying platelet clumps/giant platelets/platelet satellitism or the presence of fragmented RBCs [3,[10][11][12]. In addition to the TPC, it helps in assessing additional information like platelet size, granulation, and the phenomenon of platelet aggregation and satellitism [8].…”

Section: Discussionmentioning

confidence: 99%

“…Despite many technological advances, the problem of spurious low or high platelet counts by automated cell counters is common in routine laboratory practice [ 1 , 2 ]. Hence, most laboratories cross-check any abnormal or suspicious platelet values obtained from the cell counters by an alternative method, which includes the estimation of platelet count on the Leishman-stained peripheral blood smear or by manual method of counting platelets in a Neubauer chamber [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Estimation of Total Platelet Count From Peripheral Blood Smear Needs a Correction Factor

Sahu¹,

Mohanty²,

Adhya³

2022

Cureus

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BackgroundDespite many advances in platelet counting by cell counters, the problem of falsely low or falsely high total platelet counts (TPC) is common. Many laboratories estimate platelet count on the peripheral smear to cross-check the platelet counts. However, due to the lack of a standard calculation method, discrepant results are obtained from different laboratories leading to confusion among clinicians. We aimed to formulate a standard estimation method for platelet count on peripheral smear. MethodologyIn the first step (in 100 blood samples), we determined the ratio of the TPC obtained by the automated cell counter and the total number of platelets per oil immersion field (filed size: 0.22 mm) of the corresponding blood smears. The mean of the ratios thus obtained was designated as the "multiplication factor" to be used for visual platelet count estimation on the peripheral blood smear. In the subsequent step, validation of the same was done on another 100 samples. TPC on the peripheral smears of these samples was estimated using the above "multiplication factor" and compared with the corresponding TPC obtained on the automated cell counter. ResultsThe "multiplication factor" obtained was 9.4 x 10 3 in the first set of 100 blood samples. It was used to estimate the platelet value of the second set of 100 blood samples. ConclusionsWe found an excellent agreement between the platelet counts obtained by automated cell counters and the estimation method. We suggest the multiplication factor 9.4 x 10 3 may be used with correction for microscopic field size to estimate platelet count on peripheral smears. This method is, however, not so reliable for very low platelet counts.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%