1.Predictive value of White Blood Cell Count and Neutrophil-toLymphocyte Count ratio in classifying the severity of community acquired Pneumonia in immunocompetent patients
Armin N. Masbang ; Minette Clare O. Rosario
Philippine Journal of Internal Medicine 2019;57(2):66-72
Introduction:
White blood cell (WBC) count, from which neutrophil-to-lymphocyte count ratio (NLCR) can be derived, is commonly requested in the hospital setting among admitting patients with community acquired pneumonia (CAP). This study aims to establish the predictive value of WBC count and NLCR in classifying CAP which guides the clinicians in the choice of antibiotics and site-of-care. The researchers aim to evaluate the predictive value of WBC count and NLCR during consultation and admission in classifying patients with CAP based on the managementoriented risk stratification of the 2016 Philippine Clinical Practice Guidelines on CAP.
Methods:
This was a prospective cross-sectional study conducted in St. Luke’s Medical Center, Quezon City. Adult patients diagnosed with CAP were classified according to severity of infection based on the 2016 Philippine Clinical Practice Guidelines on CAP. WBC count of each patient was determined, and their corresponding NLCR was derived. The differences of WBC count and NLCR per risk were evaluated using chi-square and ANOVA test adjusted for the distribution of the outcome. Sensitivity and specificity of WBC and NLCR were determined for the following: (1) between CAP low risk (LR) versus CAP moderate risk (MR) and CAP high risk (HR) and (2) between CAP LR and CAP MR versus CAP HR. Receiver operating characteristic (ROC) curve was constructed to evaluate the sensitivity and specificity of WBC and NLCR in classifying. ROC curves displayed sensitivity versus 1-specificity such that area under the curve (AUC) ROC for WBC and NLCR.
Results:
Two hundred eighty (280) CAP patients from June 2016 until April 2017 were studied. Among the CAP patients, 69 (24.6%) were classified as LR, 172 (61.5%) were classified as MR, and 39 (13.9%) were classified as HR. The mean WBC count was 11,725.8 (±5,205.82)/ụl. The mean WBC per risk were as follows: 9,178/ụl for LR; 12,251/ụl for MR, and 13,916/ ụl for CAP HR. It showed that the higher the risk, the higher the mean of the WBC count (<0.00001). The mean NLCR was 8.9 (±8.4). The mean average of NLCR per risk were as follows: 5.4 for LR, 8.6 for MR, and 16.1 for HR. It showed that the higher the risk, the higher the NLCR (<0.00001). In predicting CAP patients with HR and MR from LR, the AUC of NLCR (0.700) was almost the same as that of the WBC count (0.698). In predicting CAP patients with HR from MR and LR, the AUC of NLCR (0.726) was higher than the WBC (0.621), indicating that NLCR is a fair predictive marker in distinguishing HR from MR and LR.
Conclusion
As the severity of CAP increases, the mean of the WBC count and NLCR increases. Between the two biomarkers, NLCR predicts CAP severity more than the WBC count. Furthermore, NLCR better predicts HR from MR and LR
Leukocyte Count
2.Changes of platelet count, white blood cell count, glucose concentration and pH in platelet concentrates during the four day storage
Journal of Vietnamese Medicine 1999;232(1):22-25
We studied in 40 platelet concentrates (PCs) prepared by two methods: Platelet-rich plasma (PRP) (n= 20) and buffy coat (BC) (n=10) and evaluated the changes of platelet count, white blood cell count, glucose concentration and pH during the 4 days-storage. There was not significant difference between two groups for platelet count, glucose concentration at the day 0. After 4 days, the platelet’s loss in PCs- PRP was significantly lower than that in PCs-BC (4.93x 109 Vs 7.14 x 109, p<0,05) and PCs- PRP had the lower glucose consumption than PCs- BC (53.6 mg% vs 115.9 mg%, non significant). The WBC counts and pH were higher in PCs- PRP than those in PCs-BC at day 0, but the WBC’s decreasing during the storage as not different between two groups, the pH of PCs-BC reduced more quickly than that of PCs- PRP are more stable than those in PCs- BC during 4 day storage.
Blood Platelets
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Platelet Count
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Leukocyte Count
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Glucose
3.Differential leukocyte count: manual or automated, what should it be?.
Bong H HYUN ; Gene L GULATI ; John K ASHTON
Yonsei Medical Journal 1991;32(4):283-291
Today's automated hematology analyzers capable of performing a full CBC and a differential leukocyte count (DLC) on whole blood, particularly in a closed tube system, using cytochemistry or impedance-based flow cytometry technology coupled with laser light scattering, conductivity and/or differential cell lysis, are here to stay. Their need and popularity among at least the large, cost and quality-conscious clinical laboratories have been growing for the past few years and will continue to do so in the years ahead. The efficiency and reliability of several of these analyzers in performing complete CBCD (CBC and DLC) and in flagging significant abnormalities have been tested and found acceptable with the need to review a stained blood smear or perform a manual DLC to confirm or obtain additional information on selected cases.
Automation
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Human
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Leukocyte Count/*methods
4.Annual Report on External Quality Assesment in Hematology in Korea (2003).
Jong Woo PARK ; Gye Cheol KWON ; Youn Bo PARK ; Chan Jeoung PARK ; Hyo Soon PARK ; Kyung Soon SONG ; Dong Wook YANG ; Do Hoon LEE ; Woong Soo LEE ; Wha Soon CHUNG ; Han Ik CHO ; Hyun Chan CHO ; Hyun Sook CHI ; Jong Tai CHOI ; Kyung Ja HAN
Journal of Laboratory Medicine and Quality Assurance 2004;26(1):29-45
Four trials of external quality assessment in diagnostic hematology were performed in 2003 with about 430 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, white cell differential count, red blood cell morphology and coagulation test. The response rate was more than 95%. The performance of quality assessment appeared to be gradually improved year by year.
Equidae*
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Erythrocyte Count
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Erythrocytes
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Hematology*
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Korea*
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Leukocyte Count
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Platelet Count
6.Effect of Highvolume Platelet Reduction Therapy on White Blood Cell Count and Hemoglobin Level in Patients with Thrombocytosis.
Yuan-Jun WU ; Yong WU ; Hui-Sen LI ; Bao-Chan CHEN ; Yan LIU ; Yue-Qin WU ; Si-Yuan LIANG ; Mei-Qi LIANG
Journal of Experimental Hematology 2019;27(5):1607-1611
OBJECTIVE:
To explore the effect of high volume platelet reduction therapy on the white blood cell (WBC) count and hemoglobin (Hb) level in patients with thrombocytosis.
METHODS:
Thirty-two plateletphoreses were performed for patients with thromocytosis by using ELP or MNC program of blood component isolator of COBE spectra continuous flow concentrifugation and the ACD-A preservation solution for blood as blood anticoagulant. In each treatment of patients, 2.5-3.0 tines total blood volume (TBV) were circulated, then the platelet suspension of 1/5-1/4 time TBV was prepared and collected.
RESULTS:
A single plateletpheresis took (212.53±41.54) minutes in which (8 812.63±2087.15) ml blood were treated, and (798.84±190.77) ml platelet suspension was collected. In the suspension, the platelet count was 4 486.50 (3 058.50-5 279.50)×10/L, containing 3 455.50 (2 288.68-4 226.71)×10. WBC count was 13.79 (10.21-20.72)×10/L, containing 11.90(7.81-14.40)×10. Hemoglobin concentration was (3.28±1.25) g/L,containing (2.62 ± 1.17) g. Before and after plateletpheresis, the patients' platelet count was 1 263.00 (1 052.50-1 807.50)×10/L and (778.83±247.25)×10/L(Z=4.94, P<0.01), WBC count was 9.96(6.44-14.01)×10/L and 8.59(5.37, 13.12)×10/L (Z=13.31, P<0.05), Hemoglobin concentration was (112.63 ± 24.56)g/L and (109.55 ± 24.46)g/L (t=1.68,P>0.05).
CONCLUSION
Using continuous flow centrifugation and blood component separating in plateletpheresis for the patients with thrombocytosis can obviously decrease the high ratio of platelets, and improve the effect of plateletpheresis. The high volume platelet reduction therapy can lead to decrease of WBC count to some alent, degree but WBC count still in the normal range, moreover not affect the hemoglobin level significantly.
Hemoglobins
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Humans
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Leukocyte Count
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Platelet Count
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Plateletpheresis
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Thrombocytosis
7.Correction of Platelet Count Using a Vortex in Pseudothrombocytopenia.
Duck CHO ; Bong Joon OH ; In Hwan KIM ; Choong Hyun JEONG ; Dong Wook RYANG
The Korean Journal of Laboratory Medicine 2003;23(3):151-156
BACKGROUND: Platelet clumping is a common cause of erroneous platelet counts by automated blood cell counter. The most commonly employed solution to this problem is to redraw the specimen into a different anticoagulant. However, this is unpleasant for the patient and not rapid for reporting of the corrected platelet count. Mixing of blood with a vortex mixer was evaluated as a method to disaggregate platelet clumps in blood and thus obtain accurate platelet counts. METHODS: Whole blood samples coated with ethylenediaminetetraacetic acid (EDTA) from 28 patients with platelet clumping and 20 controls without platelet clumping from July to September 2002 were mixed for 30 seconds with a vortex mixer. Platelet counts, blood smears, erythrocyte counts, Hgb, MCV and total leukocyte counts were evaluated before and after mixing. RESULTS: Vortex mixing of blood samples with platelet clumps caused an increased platelet count in 96% (27/28) and a decreased total leukocyte count in 68% (19/28). The mean platelet and total leukocyte counts of 28 blood samples before mixing were 155.0+/-89.6 (x10(3)/microL) and 12.9+/-5.5 (x10(3)/microL) and after mixing they were 249.2+/-116.2 (x10(3)/microL) and 12.0+/-5.4 (x10(3)/microL). Total erythrocyte counts, Hgb, MCV were not significantly affected by vortex mixing. Further, vortex mixing of 20 control samples had no consistent effect on each items. CONCLUSIONS: Vortex mixing of blood samples is a simple, rapid method without re-sampling in correction of erroneous platelet count induced by platelet clumps.
Blood Cell Count
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Blood Platelets
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Edetic Acid
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Erythrocyte Count
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Humans
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Leukocyte Count
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Platelet Count*
8.Annual Report on External Quality Assesment in Hematology in Korea (2004).
Jong Woo PARK ; Gye Cheol KWON ; Youn Bo PARK ; Chan Jeoung PARK ; Hyo Soon PARK ; Kyung Soon SONG ; Dong Wook YANG ; Do Hoon LEE ; Woong Soo LEE ; Wha Soon CHUNG ; Han Ik CHO ; Hyun Chan CHO ; Hyun Sook CHI ; Jong Tai CHOI ; Tae Eun JEONG ; Kyung Ja HAN
Journal of Laboratory Medicine and Quality Assurance 2005;27(1):21-36
Four trials of external quality assessment in diagnostic hematology were performed in 2004 with about 440 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, white cell differential count, red blood cell morphology and coagulation test. The response rate was more than 96%. The coefficients of variation in hemoglobin and RBC number was stable but variable in platelet number and WBC number according to measuring cell counts. Blood coagulation study was performed twice. Test results show wide variation according to measuring machine and reagents.
Blood Coagulation
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Cell Count
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Equidae*
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Erythrocyte Count
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Erythrocytes
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Hematology*
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Indicators and Reagents
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Korea*
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Leukocyte Count
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Platelet Count
9.Annual Report on External Quality Assessment in Hematology in Korea (2005).
Gye Cheol KWON ; Sun Hee KIM ; Yong Goo KIM ; Youn Bo PARK ; Jong Woo PARK ; Chan Jeoung PARK ; Hyo Soon PARK ; Jang Soo SUH ; Dong Wook RYANG ; Woong Soo LEE ; Chun Hwa IHM ; Hwan Sub LIM ; Han Ik CHO ; Hyoun Chan CHO
Journal of Laboratory Medicine and Quality Assurance 2006;28(1):27-39
Four trials of external quality assessment in diagnostic hematology were performed in 2005 with about 500 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, white cell differential count, red blood cell morphology. The response rate was more than 97%. The coefficients of variation in hemoglobin and RBC number was stable but variable in platelet number and WBC number according to measuring cell counts. Test results showed wide variation according to measuring machine and reagents.
Cell Count
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Erythrocyte Count
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Erythrocytes
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Hematology*
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Indicators and Reagents
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Korea*
;
Leukocyte Count
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Platelet Count
10.Annual Report on External Quality Assesment in Hematology in Korea (2002).
Jong Woo PARK ; Gye Cheol KWON ; Hyo Soon PARK ; Woong Soo LEE ; Chan Jeoung PARK ; Kyung Soon SONG ; Dong Wook YANG ; Yon Bo PARK ; Do Hoon LEE ; Wha Soon CHUNG ; Han Ik CHO ; Hyun Sook CHI ; Jong Tai CHOI ; Kyung Ja HAN
Journal of Laboratory Medicine and Quality Assurance 2003;25(1):35-49
Four trials of external quality assessment in diagnostic hematology were performed in 2002 with about 400 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, reticulocyte count, white cell differential count, and red blood cell morphology test. The response rate was more than 90%. The performance of quality assessment appeared to be gradually improved year by year.
Equidae*
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Erythrocyte Count
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Erythrocytes
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Hematology*
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Korea*
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Leukocyte Count
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Platelet Count
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Reticulocyte Count