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Automated reticulocyte parameters for hereditary spherocytosis screening

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Abstract

The laboratory diagnosis of hereditary spherocytosis (HS) is based on several screening and confirmatory tests; our algorithm includes clinical features, red blood cell morphology analysis and cryohaemolysis test, and, in case of positive screening, sodium dodecyl sulphate polyacrylamide gel electrophoresis as a diagnostic test. Using the UniCel DxH800 (Beckman Coulter) haematology analyser, we investigated automated reticulocyte parameters as HS screening tool, i.e. mean reticulocyte volume (MRV), immature reticulocyte fraction (IRF) and mean sphered cell volume (MSCV). A total of 410 samples were screened. Gel electrophoresis was applied to 159 samples that were positive for the screening tests. A total of 48 patients were diagnosed as HS, and seven were diagnosed as acquired autoimmune haemolytic anaemia (AIHA). Some other 31 anaemic conditions were also studied. From the receiver operating characteristic (ROC) curve analysis, both delta (mean cell volume (MCV)-MSCV) and MRV presented an area under the curve (AUC) of 0.98. At the diagnostic cut-off of 100 % sensitivity, MRV showed the best specificity of 88 % and a positive likelihood ratio of 8.7. The parameters IRF, MRV and MSCV discriminated HS not only from controls and other tested pathologies but also from AIHA contrary to the cryohaemolysis test. In conclusion, automated reticulocyte parameters might be helpful for haemolytic anaemia diagnostic orientation even for general laboratories. In combination with cryohaemolysis, they ensure an effective and time-saving screening for HS for more specialised laboratories.

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Acknowledgments

We acknowledge the help of the technical staff of the laboratory of haematology and the laboratory of automated specialised biochemistry.

Conflict of interest

The authors declare that they have no conflict of interest. We disclose any commercial affiliations as well as consultancies, stock or equity interests and patent-licensing arrangements.

Ethical standards

This study has been approved by the local ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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Authors and Affiliations

  1. Department of Clinical Chemistry, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, 1070, Brussels, Belgium

    Elena Lazarova, Frédéric Cotton & Béatrice Gulbis

  2. Laboratory of Haematology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

    Elena Lazarova & Olivier Pradier

Authors
  1. Elena Lazarova
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  2. Olivier Pradier
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  3. Frédéric Cotton
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  4. Béatrice Gulbis
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Correspondence to Elena Lazarova.

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Lazarova, E., Pradier, O., Cotton, F. et al. Automated reticulocyte parameters for hereditary spherocytosis screening. Ann Hematol 93, 1809–1818 (2014). https://doi.org/10.1007/s00277-014-2127-8

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  • DOI: https://doi.org/10.1007/s00277-014-2127-8

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