RBC Histograms and their correlation with Peripheral smear examination in anaemic patients

Abstract

Introduction: Automated haematology analysers provide the histograms of different blood cells. The interpretation of histograms need careful analysis of all the parameters including red blood cells (RBC), white blood cells (WBC) and platelet distribution curves. This
analysis is often neglected and underrated part of the hemogram generated by the analyser. If interpreted properly it has the potential to provide valuable diagnostic information even before a higher level investigation is ordered. This is certainly a time saving tool. This study was conducted to study the correlation between RBC histogram charts plotted by the automated haematology analyser and the peripheral smear findings in patients with anaemia in our tertiary care hospital, and how close are these findings with the gold standard of investigation that is microscopy. Material and method: 500 sample of patients of adult age group admitted in Chirayu
Medical College, Bhopal were studied from March 2023 to August 2023. Patients with haemoglobin less than 12.5gm/ dl were included. The blood samples were run in Mindray BC 6000 plus haematology analyser, which is a 5 part differential counter. The histogram is
obtained on the display of the cell counter. Peripheral smears were prepared from same samples of patients received in EDTA vacutainer and stained by Leishman stain. Then microscopy of stained Peripheral smears were done. The peripheral smear findings were then correlated with the histogram charts from cell counter with due knowledge of relevant clinical history.
Result: In our study of 500 patients, the histogram suggested 52.2% of cases as microcytic hypochromic anaemia, followed by normocytic normochromic anaemia 19.6%. The histogram suggested 12.6% of patients and 2.2 % of patients suffering from macrocytic
anaemia and haemolytic anaemia respectively. In 13.4 % of cases histogram showed dimorphic picture. On confirming with Peripheral Smear finding we found that 53.4% of cases showed picture of microcytic hypochromic anaemia, followed by normocytic normochromic anaemia at 18.8%. The Peripheral Smear finding suggested 11.6% of patients and 3.6 % of patients suffering from macrocytic anaemia and haemolytic anaemia respectively. In 12.6 % of cases Peripheral smear showed dimorphic picture.
Conclusion: The peripheral blood smear examination along with Histogram analysis can prove a very promising and complementary tool in diagnosis of anemias. Histogram can provide subtle information about the RBC pathology and many a times can act as time saving method.