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A simple splenic reticuloendothelial function test: counting erythrocytes with argyrophilic inclusions.

The presently accepted methods for evaluation of splenic reticuloendothelial (RE) function include 99mTc sulfur colloid spleen scan, antibody-coated autologous erythrocyte clearance, and pocked erythrocyte count. All methods involve special equipment and/or risk and inconvenience to patients. A simple method of assessing splenic RE function was developed by counting erythrocytes with argyrophilic inclusions using a simple silver stain and an ordinary microscope. To test the validity of this method, blood samples were collected from patients suspected of having hyposplenia or asplenia, including patients with history of splenectomy, sickle cell disease or trait, and newborns. Blood samples were also collected from normal adults and from patients without hyposplenia or asplenia as controls. The samples were tested by this method and compared to the pocked erythrocyte count that served as a gold standard. The results obtained by the two methods were found to be very comparable with little overlap between those from controls and patients with definite hyposplenia or asplenia. With the pocked erythrocyte count as the gold standard, this method has a sensitivity of 88.9% and a specificity of 97.1%. However, this method requires no special equipment. Staining can be applied to fresh blood smears as well as to Wright-stained smears, and the silver-stained smears are permanent.

Adolescent↗

[Clinical reference values for laboratory hematology tests calculated using the iterative truncation method with correction: Part 1. Reference values for erythrocyte count, hemoglobin quantity, hematocrit and other erythrocyte parameters including MCV, MCH, MCHC and RDW].

Age and sex dependent differences in the clinical reference values for erythrocyte count (RBC), hemoglobin quantity (Hb), hematocrit (Ht) and other erythrocyte parameters including MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin), MCHC (mean corpuscular hemoglobin concentration) and RDW (red cell distribution width), were calculated by the iterative truncation method with correction (Usui's method) using the results from tests on 6,300 patients' specimens obtained at Kyoto University Hospital. For RBC, Hb and Ht, the data obtained from the individuals below 13 years old showed the normal or sometimes log-normal distribution, but adjustment by the Xn-type variable transformation was often necessary to obtain the normal distribution for the data taken from the populations containing individuals over the age of 14. For the clinical reference values of RBC, Hb and Ht, no sex difference was observed below the age of 12. The values for males were significantly higher than those of females in the age range 13-79, and the values showed no significant sex-dependent difference at ages above 80. In females, age-dependent change of values for RBC, Hb and Ht was less prominent than in males; especially the upper limit values for females were very stable for all ages. MCV and MCH gradually increased with age both in males and females, and the MCHC remained constant in all age populations of male and female. The reference value for RDW was generated by the percentile method instead of the iterative truncation method because of the strong deviation in the distribution pattern, and the RDW values showed a gradual increase with age in both males and females.

Age Factors↗

Erythrocyte count and indices during normal pregnancy of non-smoking and smoking women.

OBJECTIVE: To compare the erythrocyte count and the erythrocyte indices of smoking and non-smoking women at different stages of normal gestation. STUDY DESIGN: In 247 non-smoking and 123 smoking healthy pregnant women the erythrocyte count and indices were compared at four different stages of pregnancy: 0-10, 10-20, 21-30 and 31-40 weeks. Exclusion criteria were a diastolic pressure > or = 90 mmHg, an endocrine disease or a coagulation disorder. A woman was considered a smoker if she smoked 4 or more cigarettes/day. Blood samples were run on the Sysmex NE-8000. RESULTS: The erythrocyte count was significantly lower in smokers than in non-smokers (3.86 T/l versus 3.96 T/l in the last 10 weeks). Comparing the erythrocyte count during the beginning and the end of pregnancy there were significant lower values in both groups (4.32 T/l to 3.96 T/l in the non-smoking and 4.24 T/l to 3.86 T/l in the smoking group). The differences in the median Hb and Ht levels were neglectable. The MCV was significantly higher in women who smoked, as was the MCH (MCV 91 fl and MCH 1.90 fmol in the non-smoking versus MCV 94 fl and MCH 1.95 fmol in the smoking group in the last 10 weeks). CONCLUSION: Smoking in pregnancy leads to a lower erythrocyte count and a higher MCV which might create a hypoxic condition of the fetus.

Adult↗

Erythrocyte count and hemoglobin levels in diabetic women.

Fasting blood glucose, erythrocyte counts hemoglobin levels of 131 Libyan diabetic women of Tripoli , Libya were determined. The respective mean values were 223 +/- 7 mg X dl-1, 4.97 +/- 0.034 X 10(6) X mm-3 and 14.4 +/- 0.127 g X dl-1. Sixty-five percent of these diabetic women were obese. The highest percent of diabetics belong to the age group 46-55 years. The increase in prevalence of diabetes correlates with an increase in obesity. A significant positive correlation was found between body surface area and fasting blood glucose levels (r = 0.65; P less than 0.001). Elevated levels of erythrocyte count and hemoglobin were present in these diabetic patients. Significant correlations were found between body surface area and erythrocyte count, as well as between fasting blood glucose levels and erythrocyte count, indicating the effect of obesity and diabetes on erythrocyte numbers. A significant correlation was found between fasting blood glucose levels and hemoglobin (r = 0.35; P less than 0.001). The elevated levels of hemoglobin present in these patients may be the result of haemoconcentration due to polyuria, which is always present in poorly controlled diabetic patients. The results suggest a close relationship between diabetes and obesity. Regulation of body weight/surface area is an important factor in the control of diabetes. The elevated levels of erythrocyte count and hemoglobin reflect poor control of blood glucose levels in these diabetic patients.

Adolescent↗

Incidence of high erythrocyte count in infants and young children with iron deficiency anemia: re-evaluation of an old parameter.

PURPOSE: To investigate the frequency of high erythrocyte count (red blood cell count >or=5.0 x 106/microL) in infants and young children with iron deficiency anemia and to document the differences in hematologic parameters at diagnosis and during iron therapy in IDA patients with and without a high erythrocyte count. PATIENTS AND METHODS: A total of 140 infants and young children aged 6 to 48 months with nutritional IDA without a history of any bleeding disorder were the subjects of this study. The patients were divided into three groups according to the severity of anemia. Group A1 children had Hb values 8.0 g/dL or less (severe anemia); group A2, 8.1 to 10.0 g/dL (moderate anemia); and group A3, 10.1-11.0 g/dL (mild anemia). All children received oral iron (3-5 mg/kg per day) for 12 weeks. Complete blood counts were done weekly during treatment. RESULTS: A total of 36 of the 140 patients (26%) had a high erythrocyte count. Of the 140 patients, 37 were in group A1, 80 in A2, and 23 in A3. The frequency of high erythrocyte count was 11%, 23%, and 61% in groups A1, A2, and A3, respectively. The patients with a high erythrocyte count had significantly higher Hb and Hct but significantly lower mean corpuscular volume and mean corpuscular hemoglobin (MCH) values than those with a low erythrocyte count (n = 104). A continuous elevation in the erythrocyte count has been observed in patients with a high red cell count, as in those with a low red cell count, after the institution of iron therapy. CONCLUSIONS: A high erythrocyte count is a common feature of iron deficiency anemia in infants and young children, with an increasing frequency from severe to moderate to mild anemia. High erythrocyte count cannot be regarded as a reliable preliminary parameter in differentiating iron deficiency from thalassemias in infants and children aged up to 48 months.

Age Factors↗

Effect of exercise on erythrocyte count and blood activity concentration after technetium-99m in vivo red blood cell labeling.

We studied the effect of exercise on blood radiotracer concentration after technetium-99m in vivo red blood cell labeling. After red blood cell labeling, 13 subjects underwent maximal supine bicycle exercise. Radioactivity, analyzed with a well counter, was measured in heparinized venous blood samples drawn at rest and during peak exercise. Changes in activity were compared with changes in erythrocyte count. Activity and erythrocyte counts increased during exercise in all 13 subjects. Percent increase in activity correlated with percent increase in erythrocyte count (r = -0.78), but did not correlate with either duration of exercise or maximal heart rate. Twenty minutes after termination of exercise, activity and erythrocyte count had decreased from peak exercise values but remained higher than preexercise values. In nine nonexercised control subjects, samples drawn 20 minutes apart showed no change in activity or in erythrocyte count. We conclude that exercise increases blood activity, primarily because of an increase in erythrocyte count. During radionuclide ventriculography, blood activity must be measured before and after any intervention, particularly exercise, before a change in left ventricular activity can be attributed to a change in left ventricular volume.

Adult↗

N-acetyl-beta-D-glucosaminidase activities, milk somatic cell counts, and blood leukocyte and erythrocyte counts in cows after heat-induced stress or after intravenous administration of adrenocorticotropic hormone.

Six midlactation, nonpregnant cows were subjected to heat-induced stress or to repeated injections of adrenocorticotropic hormone (ACTH). The heat stress (experiment 1) consisted of subjecting the cows to 7 days of fluctuating temperatures (21 C during the day, 32 C during the night). The ACTH-induced stress (experiment 2) was accomplished by giving each of the cows 100 IU of ACTH twice daily for 4 consecutive days. The cows' milk somatic cell counts (MSCC), milk N-acetyl-beta-D-glucosaminidase (NAGase) activity, quarter milk production (ie, milk production per mammary quarter), blood leukocyte counts, and plasma concentrations of NAGase were monitored in both experiments. Although heat stress did not result in significant differences in NAGase, heat stress did significantly (P less than 0.05) decrease milk production. The ACTH administrations resulted in increased milk NAGase activity, MSCC, and blood leukocyte counts, and in decreased plasma NAGase activity and quarter milk production. Therefore, milk NAGase activity and MSCC were not affected by short-term heat stress, but were increased by ACTH-induced stress. Blood erythrocyte concentrations were not affected by heat stress or by ACTH-induced stress.

Acetylglucosaminidase↗