Use of Sysmex XE‐2100 and XE‐5000 hematology analyzers for the diagnosis of malaria in a nonendemic country (France)

Abstract

Using SYSMEX analyzers, Pv, Po, and Pm infections are easy to ascertain as DIFF scattergrams are almost specific (specificity = 99.9%). Pf infection diagnosis by CBC may be a more promising tool.

AutomatedPlasmodiumdetection by the Sysmex XN hematology analyzer

“…Such a phenomenon was noted for one sample highly infected with Pf . This pseudoreticulocytosis may explain the RET/IRF ratio increase which tends to be correlated with parasite count, as previously described for the Sysmex XE-2100 analyzer 5. However, further studies are necessary to confirm these data.…”

Abnormal scattergrams and cell population data generated by fully automated hematological analyzers: New tools for screening malaria infection?

“…Characteristic abnormalities of RET count, with or without alteration of RET‐scattergram, have been previously described in the scientific literature . These anomalies were found to be dependent on parasite species and could hence be more frequently observed in patients infected by P. falciparum , while they were modest or even absent in those infected by P. vivax or P. ovale .…”

“…These anomalies were found to be dependent on parasite species and could hence be more frequently observed in patients infected by P. falciparum , while they were modest or even absent in those infected by P. vivax or P. ovale . This is probably attributable to the capability of P. falciparum to multiparasitized all RBCs (i.e both RET and mature erythrocytes), while other Plasmodium species almost exclusively infect RET or young RBCs . Notably, P. falciparum infection is often associated with parasitized RBC that resemble a reticulocyte, thus explaining the abnormalities typically found in the RET count.…”

Response to letter from Dr Jain

“…bone marrow recovery after chemotherapy?) together with shift to the right of the neutrophil cloud which can mimic some peculiar DIFF scattergrams others and us reported in malaria [1][2][3]. In conditions related to neutrophilic leukocytosis, such as in chronic myelocytic leukemia, abnormally large and/or right-shifted neutrophil cloud may be observed.…”

“…In malaria, leukocytosis is quite rare and its occurrence leads to the hypothesis of bacterial infection to be added. Eventually, we cannot exclude that in some rare instances peculiar DIFF scattergrams mimicking those described in our papers [1][2][3] and unrelated to malaria may occur, but the use of all parameters from the full blood count, together with DIFF scattergrams, may help diagnosis of malaria (either P. vivax, ovale, or malariae).…”