Utility of hyperchromic cell percentage, flags, and red cell cytograms generated by Advia-120 hematology analyzer as a p
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ORIGINAL ARTICLE
Utility of hyperchromic cell percentage, flags, and red cell cytograms generated by Advia-120 hematology analyzer as a potential screening tool in hereditary spherocytosis Sugandha 1 & Naveen Kakkar 2
&
M. Joseph John 3
Received: 19 August 2020 / Accepted: 12 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Hereditary spherocytosis (HS) is the commonest inherited red cell membrane disorder seen in clinical practice. Modern hematology analyzers generate newer parameters that can help in screening of HS. The present study focuses on the utility of red blood cell data generated by Advia-120 hematology analyzer as a screening tool for patients with HS. Blood samples from 21 patients with HS were analyzed on Advia-120 (Technicon H*1 series) analyzer. The percentage of hyperchromic cells and hyperchromic and hemoglobin concentration variance flags along with the RBC cytogram were studied. A control group of 50 healthy individuals and 50 patients with other hematological disorders was also studied. Osmotic fragility test was done in all patients with suspected HS. All hematological parameters including percentage of hyperchromic red cells were compared between the study group, healthy controls, and other hematological disorders. Twenty of the 21 patients with HS were anemic. Peripheral blood smear in all patients showed variable numbers of spherocytes (5–50%). Osmotic fragility test was positive in all patients. The mean percentage of hyperchromic cells in patients with HS-18.2 ± 13.0% was significantly higher (p < 0.0001) than that seen in the control group and in patients with other hematological disorders. Hyperchromic RBC > 6% showed a sensitivity of 100% and specificity of 99% for the diagnosis of HS. All patients showed flagging for hyperchromic cells. The RBC cytograms in all 21 patients showed significant number of RBCs plotted in the hyperchromic zone. The percentage of hyperchromic cells, hyperchromic cell flagging, and RBC cytogram pattern generated by Advia-120 hematology analyzer are useful tools in the screening of patients with suspected HS. Keywords Hereditary spherocytosis . Automated . Hyperchromic cells . Flag . Red cells
Introduction Hereditary spherocytosis (HS) is the most common inherited red cell membrane disorder seen in clinical practice with a prevalence of 1 in 5000 to 1 in 2000 in the Caucasian population [1]. It is clinically heterogeneous with patients being * Naveen Kakkar [email protected] 1
Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
2
Department of Pathology, Maharishi Makandeshwar Medical College & Hospital, Kumarhatti, Solan, Himachal Pradesh 173229, India
3
Department of Clinical Hematology, Hemato-oncology and Bone Marrow (Stem cell) Transplantation, Christian Medical College & Hospital, Ludhiana, Punjab, India
asymptomatic or presenting with moderate to severe hemolytic anemia. Complete blood count (CBC), reticulocyte count, and osmotic fragility test (OFT) are
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