Indian Journal of Pathology and Oncology


Correlation of peripheral smear with RBC indices and RBC histograms in the diagnosis of anemia


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Author Details: Sandhya V., Rashmi G.S.B

Volume : 4

Issue : 2

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 242

Article End Page : 246


Abstract

Introduction: RBC histogram with erythrocyte indices provide clue to the diagnosis of anemia .Along with Peripheral smear it is used to interpret the cause of anemia.
Aim: To correlate peripheral smear findings with RBC histogram patterns and RBCs indices to provide a better approach in the diagnosis of anemia and analyse their limitations.
Materials and Method: 500 anemic patients with haemoglobin levels of less than 11.5gm% on EDTA sample by Beckman coulter LH-780 were included in the present study, leukemia being excluded. An impression was made by examining Leishman stained peripheral smear without referring to the histogram. The RBC histogram and the RBC indices were analysed and the anemia categorised. The correlation between the diagnosis made by Peripheral smear Vs RBC histogram, indices was analysed using Cramer’s V (0.523) and Kappa statistics for agreement between the two methods.
Results: The 500 cases included 21.8%, 46%, 8.8%, 17.6% and 5.8% cases of normocytic normochromic, microcytic hypochromic, macrocytic, dimorphic and haemolytic anemia respectively by peripheral smear examination. Analysis by erythrocyte indices and histogram showed similar findings except in macrocytic, dimorphic and hemolytic anemia which were 15.6%, 15.8% and 0.8% respectively. The correlation between the diagnosis made by the two methods was statistically significant, p<0.0001 and the agreement between the two methods was moderate (0.518).
Conclusion: RBC histogram and indices should be interpreted in the light of peripheral smear which is indispensable in hemolytic and dimorphic anemia. On the contrary, histogram gives information about subtle changes well in advance of numerical parameters and subjective evaluation.

Keywords:
Histogram, Erythrocyte Indices, Peripheral Smear, Anemia, Hemolytic Anemia