New Reference Ranges in Haematology for Healthy Adults Using the Modern Sysmex XE-2100 Automated Analyser.

Abstract

Establishing clearly defined, accurate reference ranges facilitates good interpretation and effective discrimination between health and disease. These can be used to obviate the need for unnecessary follow-up medical examinations thereby reducing costs. Our data represent findings from one of the most comprehensive studies ever undertaken with the XE-2100 to establish reference ranges (RRs) in healthy adults. Early morning venous samples were collected into Greiner EDTA Vacuettes (Ref: 454286) from 221 healthy laboratory personnel (F= 159;M = 62) aged 20–63 yrs for both gender. Age groups were equally represented. Samples were processed on a Sysmex XE-2100 analyser within 1 hour of collection. NCCLS guidelines (C28-A and H3-A4) were followed throughout. Outliers were excluded, data examined for normal distribution from histograms, Q-Q normality plots, skewness and kurtosis and significance levels calculated from the Kolmogorov-Smirnov and Shapiro-Wilk tests of normality. RRs for near normally distributed parameters were calculated using means ± 2SDs. RRs for non-normally distributed parameters were calculated using the log natural transformation and the antilog of the 2.5- and 97.5- percentiles. Bold parameters shown below have near-normal distribution. Non emboldened values are non-normally distributed. P values are derived from Mann-Whitney U test for differences between males and females. New Limits Historical Limits Test of M&F diff. (P value) *=sig. diff. Haemoglobin (g/dL) M 13.7–17.2 13.0–17.5 <0.05* F 12.0–15.2 11.7–15.7 RBC (x1012/L) M 4.5–5.6 4.5–5.9 <0.05* F 3.9–5.1 3.8–5.9 Hct (L/L) M 0.40–0.50 0.40–0.52 <0.05* F 0.37–0.46 0.37–0.47 MCV (fL) M 83–98 80–100 0.090 F 85–98 80–100 MCH (pg) M 28–33 27–32 0.391 F 28–33 26–31 MCHC (g/dL) M 32–36 30–36 <0.05* F 32–35 30–36 RDW (%) M 11.6–14.1 11.0–15.0 0.067 F 12.0–14.7 11.0–15.0 Reticulocytes (x109/L) M 27–93 25–85 0.138 F 22–76 25–85 Platelets ( (x109/L) M 140–320 140–450 <0.05* F 180–380 140–450 MPV (fL) M 9.4–12.2 6.3–10.1 0.426 F 9.2–12.9 6.3–10.1 Leucocytes (x109/L) 3.6–9.2 4.0–11.0 0.854 Neutrophils (x109/L) 1.7–6.2 2.0–7.5 0.760 Lymphoctes (x109/L) 1.0–3.4 1.0–4.0 0.854 Monocytes(x109/L) 0.2–0.8 0.2–0.8 0.073 Eosinophils(x109/L) 0.00–0.4 0.04–0.4 0.847 Basophils(x109/L) 0.00–0.1 0.00–0.1 0.279 Reference limits determined for total leucocytes and neutrophils are significantly lower than historical ranges. However, leucocyte counts are at their lowest in the early morning. Our findings are in general agreement with previously published data from more limited trials undertaken in other countries.

New laboratory perspectives for evaluation of vivax malaria infected patients: a useful tool for infection monitoring

“…Determination of alterations in these parameters was based on the reference intervals established for each test ( Table A1 ). 18 , 19 , 20 , 21 , 22 All the hematological and biochemical exams were performed using automated equipment, following the standards of laboratory quality control (Pentra 80 Hematology Counter Horiba Medical, Montpellier, France; and CT 600i Automated Analyzer Wiener Laboratories, Rosario, Argentina).…”

“…The cutoff point of each parameter for change identification was established within the normal range limits. 18 , 19 , 20 , 21 , 22 The proportion of patients with values above or below the selected cut-off point was compared between the groups of acute and convalescent phases of vivax malaria. This analysis was performed in a 2 × 2 table and the results of chi-square test and the 95% confidence interval of the odds ratio were compared between the groups.…”

“… Parameters Reference value Cut-off Ref. Inflammatory markers α-1-acid glycoprotein – AGP (mg/dL) 60–120 >120 22 C-reactive protein – CRP (mg/dL) <8.0 >8.0 18 Creatine phosphokinase – CPK (mg/dL) 55–170 >170 18 Erythrocyte sedimentation – ESR (mm/h) 0–15 >15 18 Lactate dehydrogenase – LDH (U/L) 80–225 >225 18 Platelet parameters Platelet count ( n /μL) 150,000–450,000 <150,000 18 Mean platelet volume – MPV (fl) 8.4–11.4 >11.4 20 Platelet distribution width – PDW (%) 8.7–15.7 >15.7 20 Plateletcrit – PCT (%) 0.14–0.24 <0.14 20 Total leukocytes and fractions Leukocytes (cell/μL) 4000–11,000 <4000 21 Neutrophil (cell/μL) …”

Evanescence Meets Elegance: Story of Invisible Sweet Marker

“…We did a complete blood count which showed a significant low hemoglobin-7.1 g/dL (biological reference interval: 12-15.2 g/dL) with microcytosis-MCV of 59.6 fL (biological reference interval: 85-98 fL). 7 This was followed with a blood smear study which showed numerous target cells and schistiocytes. Based on these findings, we have arrived at a laboratory diagnosis of HbE homozygous with β-thalassemia, 8 though confirmation demanded molecular studies which could not be proceeded due to unavailability of resources.…”