Evaluation of schistocyte
analysis by a novel automated digital cell morphology application.
Laboratory test Patient Reference range WBC 11.1 4-10 x [10.sup.9]/L Hemoglobin 7.4 12-15 g/dL MCV 90 80-100 fL Platelet 18 150-400 x [10.sup.9]/L PT 29.3 9.3-12.4 seconds INR 2.8 1-1.3 aPTT 44.0 23-30 seconds D-dimer >5000 0-499 ng/ml Fibrinogen <35 175-375 mg/dL Schistocyte
1-2 <1/hpf LDH 1719 100-238 U/L WBC: white blood cells; MCV: mean corpuscular volume; PT: prothrombin time; INR: international normalizing ratio; aPTT: activated partial thrombo-plastin time; LDH: Lactate dehydrogenase.
The distribution of classes was skewed toward normal, schistocyte
, and target cell morphologies, which was primarily a function of prevalence among smear specimens selected for inclusion (Table 1).
Peripheral blood smears were routinely prepared from all TTP patients and frequency of the schistocyte
on the blood film was estimated as mild, moderate and severe at 1000X magnification.
Laboratory findings showed severe anaemia (haemoglobin 5.8 mg/dL), thrombocytopenia (platelet counts 9 x [10.sup.9]), increased lactate dehydrogenase activity (517 IU/L) and schistocyte
count was 3%.
Evidence for microangiopathic haemolysis should be sought by monitoring platelet count, haemoglobin, lactate dehydrogenase and schistocyte
measurements on the peripheral smear.
Red cell morpho- logy was normochromic normocytic with microsphe- rocytes and an occasional schistocyte
. Direct Coom- bs test was positive.
An occasional ([less than]1%) schistocyte
or helmet cell also may be seen.
In fact, Samantaa et al., (2016) have reported effect of chronic fluorosis toxicity in blood cells of albino rats showed different types of abnormal erythrocytes, poikilocytes, and schistocytes
Complete blood count revealed anemia (hemoglobin 9.9 g/dL), thrombocytopenia (platelet count 20,000) with microcytic hypochromic picture, and schistocytes
on peripheral blood film.
Although the laboratory thresholds used to define HELLP syndrome are not unanimous, Sibai proposed the following definition in order to be able to combine and compare the various studies in the literature: hemolysis defined as at least two of the following: 1) lactate dehydrogenase >600 IU/L; 2) presence of schistocytes
or; 3) total bilirubinemia >12 mg/L.
Patient demographics including age and sex, medical history, presenting signs and symptoms, and laboratory values [complete blood count, peripheral blood smear examination for schistocytes
, reticulocyte count, lactate dehydrogenase (LDH), haptoglobin, total and indirect bilirubin, coagulation tests, Coombs tests, creatinine and ADAMTS13 antigen, activity and antibody levels, if performed] were derived from the medical records.