Sharma Sunita, Sethi Neha, Pujani Mukta, Kushwaha Shivani, Sehgal Shivali
Lady Hardinge Medical College, New Delhi, India.
Hematology. 2013 Mar;18(2):101-5. doi: 10.1179/1607845412Y.0000000029. Epub 2012 Sep 12.
Malaria is highly prevalent and endemic in tropical countries and carries a significant health burden. The detection of malaria by light microscopy of Giemsa-stained smears is the gold standard. There are many hematological abnormalities associated with malaria like anemia, thrombocytopenia, and leucopenia; however, none of these abnormalities are specific. The present study was undertaken to assess the utility of WBC scattergram in predicting the diagnosis of malaria.
In this study all cases diagnosed as Plasmodium vivax/Plasmodium falciparum infection on peripheral smear examination were included. Their complete blood counts and WBC scattergrams obtained from XT2000i were critically evaluated. Accordingly, sensitivity, specificity, positive predictive value (PPV), and negative predictive value of detection of malaria by abnormal WBC scattergram with and without abnormal blood counts were also calculated.
A total of 2251 ethylendiaminetetraacetic acid samples were run on XT2000i hematology autoanalyzer. Out of these 148 cases of malaria were diagnosed on peripheral smear (128 P. vivax and 20 P. falciparum). While analyzing the WBC scattergrams, 233 cases including 124 (83.8%) malaria cases showed different abnormalities. Sensitivity and PPV for the diagnosis of malaria by abnormal WBC scattergram were 83.78 and 53.20%, respectively. This had increased to 98.60 and 57.25%, respectively, when cytopenias were included.
Sysmex XT-2000i is capable of detecting specific abnormalities in WBC scattergram in patients with malaria. Therefore, the presence of an abnormal WBC scattergram with thrombocytopenia in a febrile patient helps the pathologist to clinch the diagnosis of malaria.
疟疾在热带国家高度流行且为地方性疾病，带来了重大的健康负担。通过吉姆萨染色涂片的光学显微镜检查来检测疟疾是金标准。疟疾存在许多血液学异常，如贫血、血小板减少和白细胞减少；然而，这些异常均不具有特异性。本研究旨在评估白细胞散射图在预测疟疾诊断中的效用。
本研究纳入了所有在外周血涂片检查中被诊断为间日疟原虫/恶性疟原虫感染的病例。对从XT2000i获得的全血细胞计数和白细胞散射图进行了严格评估。据此，还计算了有或无血常规异常时异常白细胞散射图检测疟疾的敏感性、特异性、阳性预测值（PPV）和阴性预测值。
总共2251份乙二胺四乙酸样本在XT2000i血液学自动分析仪上进行检测。其中148例疟疾在外周血涂片上被诊断出来（128例间日疟原虫和20例恶性疟原虫）。在分析白细胞散射图时，233例病例包括124例（83.8%）疟疾病例显示出不同异常。异常白细胞散射图诊断疟疾的敏感性和PPV分别为83.78%和53.20%。当纳入血细胞减少时，这一比例分别增至98.60%和57.25%。
Sysmex XT - 2000i能够检测疟疾患者白细胞散射图中的特定异常。因此，发热患者出现异常白细胞散射图并伴有血小板减少有助于病理学家确诊疟疾。
