[Hematologic disorders--comments from clinical stand points].

Abstract

In 1992, a booklet entitled "how the primary physician can effectively use clinical laboratory tests for the initial diagnosis of hematologic disorders" was published under the direction of Members of the Committee of Japan Society of Clinical Pathology. It was very nicely edited and was potentially useful for the tentative initial diagnosis of hematologic diseases. However, the following improvements would make it more practical: 1) The definition of the primary physician should be more clearly described in the text. 2) TIBC rather than UIBC would be more appropriate to use for the diagnosis of microcytic anemias. 3) Bleeding time can be excluded from the screening tests for bleeding tendency, since it is very difficult for practitioners to perform it in their office. 4) Laboratory tests for the diagnosis of patients with anemia and jaundice should be used as a secondary screening rather than primary screening. 5) A chart showing the laboratory guide for the initial diagnosis of anemia, leukocyte abnormality and bleeding tendency would be more helpful. 6) Most of the secondary screening tests described in the text are usually ordered by clinical hematologists, thus being unnecessary to list up in the guide for the primary physician.