Erythrocytes are the most abundant and one of the most important cells in circulation in humans. They are biconcave, non-nucleated cells of the size of around 7.4 μm in diameter carrying hemoglobin. Various diseases and physiological conditions alters the morphology and contents of the red blood cells. The study of these alterations could be a major clue to the diagnosis and management of these diseases. Anemia is one of the most common morbidity associated with altered RBC morphology and content.
Aims & Objectives: The aims of this study were 1) To study RBC histogram patterns in different types of anemia (Microcytic hypochromic, Macrocytic Normocytic normochromic) 2. Comparison of automated RBC parameters in anemic patients with morphological features noticed on peripheral smear examination.
Methods: A Hospital based cross sectional study, in the Department of Pathology at Dr. SMCSI Medical College & Hospital, Karakonam, from November 2016-Novemeber 2018. Patients sent to hematology lab for evaluation of anemia were included in the study population with sample size calculated by the formula 1.962pq/d2.Blood samples of patients sent to hematology lab for evaluation of anemia by complete blood count (CBC) and peripheral smear examination.
Results: In this present study Of the total 488 anemia cases studied 286 were females, with a female to male ratio of 1.4:1.There were 121 females patients who belonged to the reproductive age group of 15-49 years. Maximum number of anemia cases (77.04%) was present in adult population of more than 15 years of age and the mean age group was 42 years.
Majority of the cases (64.58%) showed moderate anemia, 24.8% cases showed severe anemia and 10.62% cases showed mild anemia. Blood samples of 488 patients with anemia were evaluated along with the corresponding peripheral smear findings. The cases were Normocytic normochromic anemia, Microcytic hypochromic anemia, Dimorphic anemia and Macrocytic anemia as diagnosed by peripheral smear. In our study 64.2% of the cases were Normocytic normochromic anemia and 35.2% of cases were microcytic hypochromic anemia. Macrocytic anemia was observed only in 0.4% of cases and dimorphic anemia only in 0.2 % of the cases as diagnosed by peripheral smear examination.
Conclusions: RBC histogram is an automated analyzer generated graphical representation of RBCs with size being plotted on the X-axis and number being plotted along Y-axis. The study showed that subcategorization of histogram patterns did not generate any additional information from the histogram, than obtained from the broad categorization of Left shift curve, Right shift curve and Normal curve. This could probably be sample bias and hence require future studies. This study also showed that there could be overlapping of correlation of various histograms with different types of anemias diagnosed morphologically on the peripheral smear.