Objective: To reveal the compensatory features of bone marrow (BM) erythropoiesis in hereditary spherocytosis (HS) and to explore the effect of diferent hemoglobin levels on this compensation. Methods: Clinical and laboratory data of patients with HS were collected, and the peripheral blood absolute reticulocytes counts value was taken as the surrogate parameter to evaluate the ability of erythropoiesis compensation. BM erythropoiesis compensation in HS with diferent degrees of anemia were evaluated. Results: ①Three hundred and two patients were enrolled, including 115 with compensated hemolytic disease, 74 with mild anemia, 90 with moderate anemia, and 23 with severe anemia. ②Hemoglobin (HGB) was negatively correlated with serum erythropoietin in the decompensated hemolytic anemia group (EPO; rs=-0.585, P<0.001) . ③The median absolute reticulocyte count (ARC) of HS patients was 0.34 (0.27, 0.44) ×10(12)/L, up to 4.25 times that of normal people. The maximum ARC was 0.81×10(12)/L, about 10 times that of normal people. The median ARC of patients with compensated hemolytic disease was 0.29 (0.22, 0.38) ×10(12)/L, up to 3.63 times that of normal people. The median ARC of patients with hemolytic anemia was 0.38 (0.30, 0.46) ×10(12)/L, which was significantly higher than the patients with compensated hemolytic disease, up to 4.75 times that of normal people (z=4.999, P=0.003) . ④ ARC was negatively correlated with HGB in the compensated hemolytic disease group (rs=-0.177, P=0.002) and positively correlated with HGB in the decompensated hemolytic anemia group (rs=0.191, P=0.009) . There was no significant difference in the ARC among patients with mild, moderate, and severe anemia (χ(2)=4.588, P=0.101) . ⑤The median immature reticulocyte production index of the mild, moderate, and severe anemia groups was 13.1% (9.1%, 18.4%) , 17.0% (13.4%, 20.8%) , and 17.8% (14.6%, 21.8%) , respectively; the mild anemia group had lower index values than the moderate and severe anemia groups (P(adj) values were both<0.05) , but there was no significant difference between the latter groups (P(adj)=1.000) . The median immature reticulocyte count of patients in the mild, moderate, and severe groups was 5.09 (2.60, 7.74) ×10(10)/L, 6.24 (4.34, 8.83) ×10(10)/L, and 7.00 (3.07, 8.22) ×10(10)/L, respectively; there was no significant difference among the groups (χ(2)=3.081, P=0.214) . Conclusion: HGB can be maintained at a normal level through bone marrow erythropoiesis, while red blood cells are reduced in HS. However, once anemia develops, the bone marrow exerts its maximum erythropoiesis capacity and does not increase, regardless of anemia aggravation or serum EPO increase.
Bone Marrow ; Erythropoiesis ; Humans ; Reticulocyte Count ; Reticulocytes ; Spherocytosis, Hereditary

Objective To explore the feasibility of preheating in 41 ℃ water bath for 30 minutes to correct the red blood cell parameters in the specimens containing high-titer cold agglutinins(CAs). Methods Two specimens containing high-titer CAs were selected during work,and the parameters of complete blood count at room temperature or after preheating in 37 ℃ or 41 ℃ water bath were compared.The smears were stained,and the distribution of red blood cells was observed with a microscope.Further,74 specimens without CAs were collected for complete blood count,and then the test results at room temperature and after preheating at 41 ℃ were compared. Results At room temperature,the specimens containing high-titer CAs showed significantly reduced red blood cell count(RBC)and hematocrit(HCT),abnormally increased mean corpuscular hemoglobin(MCH)and mean cell hemoglobin concentration(MCHC),abnormal percents of hemoglobin(HGB)and RBC,and aggregation of a large number of red blood cells.After being preheated at 37 ℃ for a certain time,the specimens demonstrated obviously improved parameters while still aggregation of a small number of red blood cells.After being preheated at 41 ℃ for 30 minutes,the specimens showed significantly increased RBC,normal HCT,MCH,and MCHC,and evenly distributed red blood cells.The 74 specimens without CAs showed the comparability was ≥80% between room temperature and preheating at 41 ℃ for 30 minutes or 60 minutes. Conclusion We can preheat the specimens containing high-titer CAs in a water bath at 41 ℃ to obtain accurate red blood cell parameters.
Cryoglobulins ; Erythrocyte Count ; Erythrocytes ; Feasibility Studies ; Hematocrit

Animals ; Cause of Death ; Diagnosis ; Dogs ; Erythrocyte Count ; Fourier Analysis ; Incidence ; Least-Squares Analysis ; Leukocyte Count ; Mass Screening ; Methods ; Principal Component Analysis

BACKGROUND: Petrol is the non-specific term for petroleum which is used for inside combustion of engines. Petrol filling workers are highly vulnerable to occupational exposure to these harmful substances which lead to hemato-toxicity and blood disorders such as leukemia, aplastic anemia, and dysplastic bone marrow. Thus, this study was aimed to assess hematological parameters of petrol filling workers in Gondar town, Northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted from January to March 2019 in Gondar town, Northwest Ethiopia. A total of 110 study participants comprising 55 study groups and 55 controls group were recruited by a convenient sampling technique. Socio-demographic data were collected using a structured questionnaire, and 3 ml of venous blood was collected for the determination of hematological parameters. The data were entered into Epi info 7.2.0.1 and analyzed by SPSS version of 20. Mean, standard deviation, median, and interquartile ranges were used to present the data. Independent t test and Mann-Whitney U test were used to compare the mean or median difference between parametric and non-parametric hematological parameters, respectively. Moreover, Pearson product-moment and Spearman's rank-order bivariable correlations analyses were used to describe the correlation between hematological parameters and duration of exposure to petrol. A P value of ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that mean red blood cell count and hemoglobin level as well as the median hematocrit, mean cell hemoglobin concentration, platelet count, absolute lymphocytes count, and red cell distribution width values of petrol filling workers showed a significant increment compared with the control group. On the other hand, the mean cell hemoglobin value of petrol filling workers showed a significant decrement compared with healthy controls. Moreover, the duration of exposure to petrol showed a significant positive correlation with red blood cell count and mean cell hemoglobin concentration; however, a significant negative correlation was observed with mean cell volume. CONCLUSION This study showed that the majority of hematological parameters of petrol filling workers showed an increment compared with healthy controls which might be associated with exposure to petrol chemicals. However, further longitudinal study with a larger sample size should be conducted to explore the impact of petrol exposure on hematopoiesis.
Adult ; Cross-Sectional Studies ; Erythrocyte Count ; Erythrocyte Indices ; Ethiopia ; Female ; Hematocrit ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Occupational Exposure ; analysis ; Oil and Gas Industry ; Platelet Count ; Time Factors ; Young Adult

BACKGROUND: Microcytic anemia, the most common form of anemia in children and adolescents, is a heterogeneous group of diseases that is acquired or inherited. We assessed the frequency and causes of microcytosis in children and adolescents with the sickle cell trait (SCT). METHODS: This descriptive study included 95 subjects (49 males and 46 females) with SCT who attended Basra Center for Hereditary Blood Diseases for evaluation. Investigations included complete blood count, high performance liquid chromatography, capillary electrophoresis, and measurement of serum ferritin and transferrin levels. RESULTS: SCT subjects had a low hemoglobin (Hb) concentration (9.79±1.75 g/dL), low mean corpuscular volume (MCV, 67.43±9.22), low mean corpuscular Hb (21.15±3.64), and a normal red cell distribution width (RDW, 14.00±2.30). Among 95 SCT subjects, 81 (85.26%) had microcytosis, 12 (12.63%) had normal MCV, and 2 (2.11%) exhibited macrocytosis. Sixty-three (77.78%) SCT subjects with microcytosis were iron deficient, and 18 (22.22%) had normal iron levels. The mean serum ferritin and HbA2 levels were significantly lower, while the RDW, sickle Hb, and serum transferrin levels were significantly higher in patients with microcytosis and iron deficiency compared to non-iron deficient subjects (P<0.05). Correlation coefficients did not reveal a significant association between the MCV and iron status of SCT subjects (P>0.05). CONCLUSION: Despite the frequent occurrence of iron deficiency in SCT subjects, co-inheritance of alpha-thalassemia seemed to be the cause of low MCV in non-iron deficient individuals with microcytosis. Genetic analysis is required to understand the genetic basis of this phenomenon.
Adolescent ; alpha-Thalassemia ; Anemia ; Blood Cell Count ; Child ; Chromatography, Liquid ; Electrophoresis, Capillary ; Erythrocyte Indices ; Ferritins ; Hematologic Diseases ; Humans ; Iraq ; Iron ; Male ; Sickle Cell Trait ; Transferrin

Two trials were conducted with proficiency tests for complete blood cell count (CBC) and blood cell morphology as part of the 2018 Routine Hematology Program of the Korean Association of External Quality Assessment Service. Three different control samples were sent for CBC testing and two blood cell morphology pictures were posted on the laboratory website during each trial. The mean response rates of the 1,719 participating laboratories were 97.4% and 37.2% for CBC and blood cell morphology, respectively. The distribution of equipment for CBC testing was comparable to that of the previous year. The coefficient of variation (CV) ranges were determined as 3.5%–4.1%, 1.9%–2.7%, 1.4%–2.8%, 4.5%–5.3%, and 5.4%–6.9% for white blood cell counts, red blood cell counts, hemoglobin, hematocrit, and platelet counts, respectively. The concordance rate ranged from 83.0% to 97.5% in blood cell morphology tests. We observed a continuous increase in the number of participating laboratories and a trend towards a decrease in the CVs of platelet counts compared to those in 2016. Values of the other assessed parameters were similar to those of the previous year.
Blood Cell Count ; Blood Cells ; Erythrocyte Count ; Hematocrit ; Hematology ; Laboratory Proficiency Testing ; Leukocyte Count ; Platelet Count

Plasma homocysteine level and megaloblastic anemia status are two factors that can affect the quality of life of patients with multiple sclerosis (MS). We conducted this study to determine the effect of vitamin B12 and folic acid supplementation on serum homocysteine, megaloblastic anemia status and quality of life of patients with MS. A total of 50 patients with relapsing remitting multiple sclerosis (RRMS) included in this study which divided into 2 groups. The vitamin group received 5 mg folic acid tablet daily and 3 doses of vitamin B12 (1,000 mcg) injection and the other group received placebo and normal saline injection (same doses). The quality of life was measured by using Multiple Sclerosis Quality of Life-54 questionnaire (MSQOL-54). Fully automated fluorescence polarization immunoassay was used to measure serum homocysteine, vitamin B12 and folate. Complete blood count blood test was conducted to determine the anemia status. The mean homocysteine level reduced by 2.49 ± 0.39 µmol/L (p = 0.001), hemoglobin increased from 11.24 ± 1.54 to 13.12 ± 1.05 g/dL (p = 0.001), and mean corpuscular volume decreased from 95.50 ± 6.65 to 89.64 ± 4.24 in the vitamin group (p = 0.001). There was a significant improvement in the mental field of life quality in the placebo group (37.46 ± 19.01 to 50.98 ± 21.64; p = 0.001), whereas both physical and mental fields of quality of life were improved significantly in the vitamin group (40.38 ± 15.07 to 59.21 ± 12.32 and 29.58 ± 15.99 to 51.68 ± 18.22, respectively; p = 0.001). Serum homocysteine level decrease and anemia status improvement with vitamin B12 and folic acid supplementation reveal the potential role of these two vitamins in improving the life quality of MS patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trials Identifier: IRCT2015100313678N7
Anemia* ; Anemia, Megaloblastic ; Blood Cell Count ; Erythrocyte Indices ; Fluorescence Polarization Immunoassay ; Folic Acid* ; Hematologic Tests ; Homocysteine* ; Humans ; Multiple Sclerosis* ; Multiple Sclerosis, Relapsing-Remitting ; Plasma ; Quality of Life* ; Vitamin B 12* ; Vitamins*

PURPOSE: To compare the efficacy of inflammatory markers, the Laboratory-score, and a new laboratory combined model for predicting serious bacterial infection (SBI) in young febrile children.METHODS: The presence of SBI was reviewed in previously healthy children aged 3 years or younger with fever (> 38℃) who visited the emergency department from 2017 through 2018. Areas under the curves (AUCs) of the receiver operating characteristic curve for SBI were compared with individual inflammatory markers (white blood cells [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], procalcitonin [PCT], and urine WBC count), the Laboratory-score, and a laboratory combined model. The latter model was developed using logistic regression analysis including ESR, CRP, and PCT.RESULTS: Of the 203 enrolled children, SBI was diagnosed in 58 (28.6%). For SBI prediction, the Laboratory-score showed 51.7% sensitivity (95% confidence interval [CI], 38.2%–65.0%) and 83.5% specificity (95% CI, 76.4%–89.1%). The AUC of the Laboratory-score (0.76) was significantly superior to the values of all individual inflammatory markers (WBC, 0.59 [P = 0.032]; ESR, 0.69; and CRP, 0.74 [P < 0.001]) except that of PCT (0.77, [P < 0.001]). The AUC of the laboratory combined model (0.80) was superior to that of the Laboratory-score (0.76) (P < 0.001).CONCLUSION: In this study, the new laboratory combined model showed good predictability for SBI. This finding suggests the usefulness of combining ESR, CRP, and PCT in predicting SBI.
Area Under Curve ; Bacterial Infections ; Blood Cells ; C-Reactive Protein ; Child ; Emergency Medicine ; Emergency Service, Hospital ; Erythrocyte Count ; Fever ; Humans ; Logistic Models ; Pediatrics ; ROC Curve ; Sensitivity and Specificity

OBJECTIVE: To explore the serological characteristics of patients with autoimmune hemolytic anemia（AIHA） and analyze its clinical efficacy and safety of incompatible red blood cell transfusion. METHODS: Sixty AIHA patients admitted in our hospital from January 2014 to January 2018 were selected. The blood type serological characteristics of 60 patients were analyzed retrospectively. According to the type of autoantibody and the composition of different red blood cells, the efficacy and safety of erythrocyte infusions were evaluated respectively. RESULTS: The screen results of irregular antibody in 60 AIHA patients were positive, and the direct anti-human globulin test also was positive, including 8 cases of cold autoantibodies (13.33%), 49 cases of IgG warm autoantibodies (81.67%), and 3 cases of warm cold double autoantibodies (5%). The irregular anti-body identification test confirmed the existence of homoantiboby in 17 cases (28.33%). Out of 60 cases 34 received incompatible red blood cell (RBC) infusion for 108 time including ABO homotype non washing RBC (81 tirnes) and O type washing RBC (27 times). The infusion results showed that the total [JP2]effective rate was 57.41(62/108), total partial effective rate was 14.81% (16/108) and total ineffective rate was 27.78% (30/108).The infusion of ABO homotype non-washing RBC for 81 time showed that the effective rate was 58.02%[JP] (47/81) , partial effective rate was 12.35 (10/81) and ineffective rate was 29.67% (24/81); the infusion of O type washing RBC for 27 times showed that the effective rate was 55.56% (15/27), partial effective rate was 22.22% (6/27) and ineffective rate was 22.22% (6/27), there was no significant difference in effective rate between 2 kinds of infusion (P>0.05). The comparison of different antibody type infusion showed that in the infusion of IgM cold autoantiboay for 12 times, the effective rate was 41.67% (5/12), partial effective rate was 33.33% (4/12) and ineffective rate was 25% (3/12); in the infusion of IgG warm antoantibody for 93 times. The effective rate was 58.06% (54/93),partial effective rate was 12.90% (12/93) and ineffective rale was 29.04% (27/93), there was also no significant difference in effective rate between 2 kinds of infusion(P>0.05). However, in infusion of cold/warm double autoantibody for 3 times, the effective rate was 100% (3/3), moreover, the hemotytic reaction of infusion was not observed during the treatment . CONCLUSION The infusion of ABO homotype non-washing RBC and O type washing RBC both possess the high safely and efficacy for treatment of patients with AIHA, but the use of ABO homotype non-washing RBC can effectively avoid the excessive use of O type washing RBC.
Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Erythrocyte Count ; Erythrocytes ; Humans ; Retrospective Studies ; Tics

OBJECTIVE: To establish the reference intervals of the hematological parameters in normal adult people of Xuzhou erea. METHODS: The red blood cells (RBC), platelets, white blood cells (WBC) and related parameters were detected by hematoanalyzers in 82514 healthy people including 41257 males and 41257 females in the Medical Center of the Affiliated Hospital of Xuzhou Medical University. RESULTS The range of RBC count: (4.33-5.51) ×10/L in male and（3.82-4.85）×10/L in female, the range of Hb level: (132-172) g/L in male and（107-145）g/L in female, the range of HCT: 40 %-50 % in male and 34 %-44 % in female, the range of platelet count: (113-268) ×10/L in male and (126-289) ×10/L in female, the range of WBC count: (4.00-9.40) ×10/L in male and （3.54-9.30）×10/L in female, the range of NEUT count: (1.91-5.76) ×10/L in male and（1.67-5.30）×10/L in female, the range of MONO count: (0.18-0.58) ×10/L in male and（0.16-0.52）×10/L in female, the range of LYM is（1.3-3.4）×10/L in male and（1.2-3.1）×10/L in female, etc.Conclusion: There is significant difference in the blood cell parameters between Xuzhou and other areas. Among them, the lower limit of Hb reference interval for adult women in Xuzhou area is obviously lower, and the upper and lower limits of adult Plt reference interval are significantly lower than other areas in China and abroad. The upper and lower limits of the WBC reference interval are close to the domestic areas, but lower than that in some foreign regions. Through this survey, the reference intervals of different hematologic parameters of healthy people in Xuzhou area primarily has been established, Some of the indexes, such as RBC, Hb, HCT, and Plt have significant sex differences. The reference intervals for them have been estublisted respectively.
Adult ; China ; Erythrocyte Count ; Female ; Humans ; Leukocyte Count ; Male ; Reference Values ; Surveys and Questionnaires