Upload
fernando-ramirez
View
21
Download
0
Embed Size (px)
DESCRIPTION
Interesante presentación y análisis de casos relacionado a la Hematología Automatizada
Citation preview
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
3-Diff Clinical Cases Study
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
RBC Morphology and relative disease
WBC Morphology and relative disease
PLT Morphology and relative disease
◆
◆
◆
Case presentation
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
RBC Morphology and relative disease
Microcytic anemia
Normocytic anemia
Macrocytic anemia
Iron deficiency anemiaβ-Globin aplastic anemia
Aplastic anemia
Megaloblastic anemia
Nutrition deficiency anemia
Some liver disease anemia
MCV,RDW application
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Anemia classification
MCV range
MCV / RDW phenomenon
Possible Pathology
Microcytic anemia (symmetrical)
MCV<80 MCV value is decreasingRDW value is normal
ThalassemiaSecondary anemia
Microcytic anemia (non-symmetrical)
MCV<80 MCV value is decreasingRDW value is increasing
Iron deficiency anemiaβ-Globin aplastic anemia HbH diseases
Microcytic Anemia :Characterized by small red cells
MCV,RDW diagnosis using
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
MCV,RDW diagnosis using
Anemia classification
MCV range MCV / RDW phenomenon
Possible Pathology
Normocytic anemia (symmetrical)
80<MCV<100 MCV value is normal,RDW value is normal
Aplastic anemia; Leukemia; Chronic liver disease; Acute blood loss; Hereditary spherocytosis
Normocytic anemia
(non-symmetrical)
80<MCV<100 MCV value is normalRDW value is increasing
Nutrition deficiency anemia; Pre-iron deficiency; Hemoglobinopathy anemia ; Myelofibrosis,; Sideroblastic anemia
Normocytic anemia is when the overall Hb levels are decreased, but the red blood cell size (MCV) remains normal.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
MCV,RDW diagnosis using
Anemia classification
MCV range
MCV / RDW phenomenon
Possible Pathology
Macrocytic anemia(symmetrical)
MCV>100 MCV value increasing;RDW value is normal
Myelodysplastic syndromeMDS, Some aplastic anemia,
Macrocytic anemia(non-symmetrical)
MCV>100 MCV value increasing; RDW value increasing
Megaloblastic anemia,Some liver disease
anemia.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Iron Deficiency Anemia
Manual Differential SmearManual Differential Smear
RBC Morphology:
Microcytosis:+++
Anisocytosis:+++
Poikilocytosis:+
Hypochromic :++
Pm: possible presence of large platelet, platelet coagulation, small red blood cell, cell debris or fibrin. Pl: excessive large platelet
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
β-Globin Aplastic Anemia
Manual Differential SmearManual Differential Smear
Microcytosis :+++
Anisocytosis:+++
Target cell:++
Hypochromic :++
RBC Morphology:
Pm: possible presence of large platelet, platelet coagulation, small red blood cell, cell debris or fibrin.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Microcytic anemia (non-symmetrical)
MCV<80 MCV value is decreasingRDW value is increasing
Iron deficiency anemiaβ-Globin aplastic anemia
RDW-CV
RDW-CV
RDW-SD
RDW-SD
Iron Deficiency Anemia
β-Globin Aplastic Anemia
RDW-SD is the most reliable discrimination between IDA and β-Globin Aplastic Anemia
Iron Deficiency Anemia β-Globin Aplastic Anemia
(“H” Flag)
(“L” Flag)
(“H” Flag)
(“H” Flag)
Differentiate Diagnosis
VS
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Megaloblastic Anemia
Macrocytic anemia (non-symmetrical)
MCV>100 MCV value is increasing RDW value is increasing
Megaloblastic anemia
Manual Differential SmearManual Differential Smear
Macrocytosis:++
RBC Morphology:
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Anisocytosis
Manual Differential SmearManual Differential Smear
Anisocytosis:+++
RBC Morphology:
Pm: possible presence of large platelet, platelet coagulation, small red blood cell, cell debris or fibrin. Pl: excessive large platelet
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
RBC Morphology and relative disease
WBC Morphology and relative disease
PLT Morphology and relative disease
leukemia
Neutrophilia
Parasitic infection
Infectious mononucleosis
◆
◆
◆
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Neutrophilia
Manual Differential (N=200)
Neutrophils 90.5%
Lymphocytes 5%
Monocytes 3.5%
Eosinophils 1%
Basophils 0%
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Rm Indicates at least two R flags.
Rm Indicates at least two R flags.
R2 Indicates abnormality between the lymphocyte hump and the mid-sized cell area.
R3 Indicates abnormality between the mid-sized cell area and the granulocytes.
Parasitic infection
Manual Differential (N=200)
Neutrophils 33.5%
Lymphocytes 32%
Monocytes 6.5%
Eosinophils 27.5%
Basophils 0.5%
R2: possible presence of abnormal lymphocyte, plasma cell, atypical lymphocyte, original granulocytes in the sample and eosinophilia or basophilia.R3: possible presence of immature granulocytes, abnormal sub-population in the sample, or eosinophilia.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
R2 Indicates abnormality between the lymphocyte hump and the mid-sized cell area
Infectious mononucleosis
Manual Differential (N=200)
Neutrophils 20%
Bands 5%
Lymphocytes 19%
Atypiacl LYM 55%
Monocytes 0%
Eosinophils 1%
Basophils 0%
R2: possible presence of abnormal lymphocyte, plasma cell, atypical lymphocyte, original granulocytes in the sample and eosinophilia or basophilia.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Rm Indicates at least two R flags.
R2 Indicates abnormality between the lymphocyte hump and the mid-sized cell area.
R3 Indicates abnormality between the mid-sized cell area and the granulocytes.
Chronic Granulocytic Leukemia
Manual Differential (N=200)
Promyelocyte 2%
Myelocyte 11%
Metamyelocyte 5%
Neutrophils 26%
Bands 26%
Lymphocytes 11%
Monocytes 7%
Eosinophils 1%
Basophils 11%
R2: possible presence of abnormal lymphocyte, plasma cell, atypical lymphocyte, original granulocytes in the sample and eosinophilia or basophilia.R3: possible presence of immature granulocytes, abnormal sub-population in the sample, or eosinophilia.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Manual Differential (N=200)
Lymphoblast 1%
Neutrophils 3%
Lymphocytes 95%
Monocytes 1%
Eosinophils 0%
Basophils 0%
Chronic Lymphocytic Leukemia
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Acute myeloblastic leukemia
Manual Differential (N=200)
Myeloblast 87%
Neutrophils 2%
Lymphocytes 11%
Monocytes 0%
Eosinophils 0%
Basophils 0%
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Acute monocytic leukemia
Manual Differential (N=200)
Hemocytoblasts 44%
Neutrophils 3%
Lymphocytes 10%
Monoblast 36%
Monocytes 6%
Eosinophils 1%
Basophils 0%
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Therapy TraceAcute leukemia
Manual Differential (N=200)
Blasts 24%
Neutrophils 4%
Lymphocytes 28%
Monoblast 38%
Monocytes 6%
Eosinophils 0%
Basophils 0%
Period of chemotherapy
1th Day 5th Day 7th Day
WBC
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
RBC Morphology and relative disease
WBC Morphology and relative disease
PLT Morphology and relative disease
Thrombocytosis
◆
◆
◆
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Thrombocytosis
Manual Differential SmearManual Differential Smear
Excessive platelet no platelet coagulation
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Other Abnormal Histograms
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Histogram AlarmRm Indicates at least two R flags.
R1 Indicates abnormality on the left side of the lymphocyte hump.
R2 Indicates abnormality between the lymphocyte hump and the mid-sized cell area.
R3 Indicates abnormality between the mid-sized cell area and the granulocytes.
R4 Indicates abnormality on the right side of the neutrophilic granulocyte hump.
Pm Indicates blur demarcation between the platelet and red blood cell area.
Ps Indicates excessive small PLTs.
Pl Indicates excessive large PLTs.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Parameter flags
”H” Exceed the upper limit of the reference range
“L” Exceed the lower limit of the reference range
***
The result is either unreliable or out of the operating range
WBC result is less than 0.5 109/L
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
No differential result
Abnormal histogram
No differential result because the WBC histogram is over-narrowly compressed.
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
No differential result because WBC count result is less than a certain value (WBC < 0.5)
No differential result
Abnormal histogram
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
No differential result because the peak of WBC histogram lies in the middle of the histogram and
thus cannot identify the type of peak cells
No differential result
Abnormal histogram
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Increased nucleated erythrocytes or interference or inadequate lyse
Abnormal histogram
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Abnormal histogram
No lyse reagent or poor lyse
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Severe interference in WBC channel
Abnormal histogram
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Increased lymphocytes
Abnormal histogram
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Increased mid-sized cells
Abnormal histogram
BC-3000Plus Auto Hematology Analyzer (V3.0)Automated Hematology Analyzer 3-Diff
Increased neutrophilic granulocytes
Abnormal histogram