To Evaluate Sensitivity of Microcyte% and Macrocyte% Parameters in Comparison with Peripheral Blood Smear in Normocytic Normochromic Anemia Patients

Assessing Sensitivity of Hematological Parameters from Automated Cell Counter Compared to Peripheral Blood Smear in Normocytic Normochromic Anemia

Abstract

Objective: To compare the sensitivity of microcyte and macrocyte percentage given by the automated cell counter with peripheral blood smear (PBS) in normocytic normochromic (NCNC) anaemia, and to set a normal range for microcyte and macrocyte% using the data from normal control samples.
Methods: It is a cross-sectional study; whole blood samples (EDTA vacutainer) were run on a six-part cell counter, and peripheral blood findings were entered into an Excel sheet. Inclusion criteria: Age more than 18 years and having NCNC anemia. Exclusion criteria: Patients with a history of recent blood transfusion or on haematinics.
Results: A total of 240 samples were studied. Research use only (RUO) microcyte% was 44.16%, RUO macrocyte% was 27.5%, and the mixed cell population group was 15.83%. Sensitivities of both research-use-only parameters were 100%, with specificities of 95% for RUO–microcyte% and 97.7% for RUO–macrocyte%, whereas diagnostic accuracy was 97.5% for RUO–microcyte% and 98.3% for RUO–macrocyte%.
CONCLUSION: Microcyte and macrocyte percentages provided by the machine are more sensitive, as they can screen millions of RBCs and are not dependent on the observer’s skills, compared to PBS examination. Depending on the percentage of microcytic or macrocytic cells, we can recommend further confirmatory biochemical tests. Thus, we can identify a treatable underlying cause.