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Editor-in-chief
Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada


Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091



BC: Articoli scritti da P. Dominoni

Variabilità biologica dei parametri dell’esame emocromocitometrico in soggetti sani
Biological variation estimates of complete blood count parameters in healthy subjects
<p>Background: the complete blood count (CBC) is the test more frequently requested in clinical practice. Therefore, estimating the biological variation (BV) of CBC parameters is essential for assessing the analytical performance of hematological analyzers and for enabling accurate data interpretation and appropriate clinical management. This study was aimed to define BV estimates and reference change value (RCV) of CBC parameters.<br />Methods: the study population consisted of 21 healthy volunteers, who had BV of CBC parameters assessed with Sysmex XN. The study protocol, the analytical measurements and the statistical analysis were carried out according to current recommendations of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM).<br />Results: Within-subject BV ranged between 0,3% for mean cell hemoglobin (MCH) and 19,7% for immature granulocytes (IG), whilst between-subjects BVs ranged between 0,9% for mean corpuscolar haemoglobin concentration (MCHC) and 66,6% for microcytic red blood cells (Micro-R). The RCV ranged between 2,3% for MCH and 73,5% for IG.<br />Conclusion: This study has allowed the estimation of BV of many CBC parameters, some of which have not been currently explored, thus leading the way to use RCV calculated according to time of monitoring and/or differentiated by sex.</p>
Biochimica Clinica ; 43(4) 384-393
Contributi Scientifici - Scientific Papers
 
Tre neonati con sindrome di Down ed alterazioni ematologiche
Three neonates with Down syndrome and hematological abnormalities
<p>Three neonates with Down syndrome and hematological abnormalities. We report three cases of neonates with Down syndrome. In the first newborn, the complete blood count (CBC) showed leukocytosis (30x109/L). The presence of rare blasts, with morphological characteristics attributable to megacaryocytic blasts, were appreciated at the review of peripheral blood. In the second case the patient was hospitalized for severe anemia and neutropenia. The visual inspection of the peripheral blood smear showed the presence of rare undifferentiated blasts. The third patient was a premature neonate, with fetal hydrops. The CBC showed 172x109/L leukocytes and anemia. The peripheral blood smear showed erythroblasts and dysplastic platelets, prevalence of blasts, some of them with cytoplasmic blebs. In the all cases the diagnosis was Transient Abnormal Myelopoiesis (TAM), rather frequent in patients with Down syndrome. It is a transient syndrome characterized by the presence of megacaryoblasts in peripheral blood and mutation of the GATA1 gene. The information obtained by the visual inspection of the peripheral smears, could be important for a correct diagnosis, especially when the CBC data are not particularly abnormal</p>
Biochimica Clinica ; 42(4) e47-e49
Casi Clinici - Case Report
 
Utilità della determinazione della frazione delle piastrine immature nella diagnostica delle trombocitopenie autoimmuni
Role of the determination of immature platelet fraction in the diagnosis of autoimmune thrombocytopenia
<p>A 34 years old woman presented progressive severe thrombocytopenia, without major bleeding. The diagnostic tests for systemic lupus erythematosus, HIV infection and HCV infection, were negative. The platelet count was 9x10<sup>9</sup>/L, with elevated immature platelet fraction (IPF). Bone marrow aspirate was normal; the final diagnosis was immune thrombocytopenia (ITP). ITP is an autoimmune disease characterized by low platelet count in the absence of other causes of thrombocytopenia. IPF is a parameter of Sysmex hematological analyzers that measures young platelets in peripheral blood. It is elevated in peripheral platelet destruction and it is low in hypoproliferative thrombocytopenias, making it useful in differential diagnosis. This case report demonstrates the utility of IPF in diagnosis, management and follow up of ITP.</p>
Biochimica Clinica ; 42(3) e40-e42
Casi clinici - Case report
 
Conteggio e contenuto di emoglobina reticolocitario in un caso di grave anemia
Reticulocyte count and hemoglobin content in a case of severe anemia
<p>A 4 years old child from Sry Lanka was admitted in our hospital after several blood transfusions for severe anemia in her country. Very low hemoglobin (65 g/L) and ferritin (&lt;1 ng/mL) concentrations were detected, consistent with iron deficiency anemia. The reticulocyte count and the hemoglobin content (Ret-He) were low (49,20x10<sup>9</sup>/L and 13.7 pg respectively). An important number of causes of iron deficiency anemia were excluded. The patient was treated with iron infusion for two weeks, with good recovery of hemoglobin levels iron stores, Ret-He and reticulocyte number. The patient was then treated with oral iron supplementation, but a considerable decrease of Ret-He and reticulocyte count was observed, so the infusive therapy was reintroduced. Diagnosis and treatment were optimized by the synergy between the clinical laboratory and pediatricians, utilizing these hematological parameters. The blood transfusions could thus be stopped and the bone marrow biopsy could be avoided. This case demonstrates the importance of the reticulocyte count and the Ret-He in the management of iron deficiency anemia.</p>
Biochimica Clinica ; 41(2) e09-e12
Casi clinici - Case report
 
Confronto tra l’applicazione “body fluid” di due analizzatori ematologici e il metodo in microscopia ottica per l’analisi cellulare del liquido cefalorachidiano
Comparison between “body fluid” mode of two hematology analyzers and the microscopy method for cellular analysis of the cerebrospinal fluid
M. Seghezzi  |  T. Mecca  |  P. Dominoni  |  E. Lochis  |  C. Saleri  |  B. Manenti  |  A. Crippa  |  S. Buoro  | 
<p>In the cerebrospinal fluid (CSF), the white blood cell count (WBC) and cell differentiation in mononuclear (MN) and polymorphonuclear (PMN) cells are useful tools in the diagnosis of central nervous system disease. We evaluated the analytical performance of the &ldquo;body fluid&rdquo; module of the hematology analyzers Mindray BC-6800 and Sysmex XN-9000 in the cytometric analysis of the CSF. 110 CSF samples were collected and analyzed with BC-6800, XN-9000 and evaluated by optical microscopy (OM). The diagnostic concordance between each analyzer and OM, as well as between the two analyzers were evaluated.The comparison between each analyzer and OM showed correlation coefficients ranging from 0.65 to 0.99 and bias ranging from 0.06x10<sup>6</sup> cell/L to 19.9x10<sup>6</sup> cell/L. The comparison between BC-6800 and XN-9000 showed a good correlation for total cell counts, WBC, MN and PMN (both in absolute and percentage values) with a correlation coefficient ranging from 0.83 to 0.98 and bias ranging from -0.2 to -43.8x10<sup>6</sup> cell/L. The introduction of automated methods for CSF analysis could be very useful in the routine work of a laboratory analysis.</p>
Biochimica Clinica ; 40(4) 322-327
Contributi scientifici - Scientific Papers
 
Determinazione degli intervalli di riferimento dell’esame emocromocitometrico eseguito con analizzatore Sysmex XN 9000
Evaluation of reference intervals for complete blood count on Sysmex XN 9000
<p>We aimed to define reference&nbsp;intervals for complete blood count in 240 apparently healthy Italian adults (120 males and 120 females) using Sysmex&nbsp;XN 9000 platform, as recommended by international standards. The recruitment criteria for reference individuals were&nbsp;based on negative anamnesis and physiological serum concentrations of glucose, creatinine, transaminases, ferritin&nbsp;and C-reactive protein. The results were comparable to those previously generated on different European&nbsp;populations. Interesting results were found for some research parameters, for which limited information was available&nbsp;in Italian populations so far. With regard to reticulocyte-related parameters, a significant gender difference was found&nbsp;for reticulocyte hemoglobin, highly fluorescent reticulocyte fraction and delta-He, which represents the difference in&nbsp;hemoglobin content between reticulocytes and erythrocytes. The results also support the reference interval of&nbsp;immature platelet fraction observed in previous studies, except for the absolute value for which larger range and&nbsp;higher values were found. For leukocyte morphological and functional parameters, we were able to define reference&nbsp;intervals in the whole study population as well as in male and female subgroups, since gender-related differences&nbsp;were observed for some parameters.</p>
Biochimica Clinica ; 39(4) 256-263
Contributi scientifici - Scientific Papers
 
Evaluation of Sysmex XE-2100 for enumeration and differentiation of cellular elements in peritoneal and pleural fluids
<p>The aim of this study was to evaluate the performance of Sysmex XE-2100 for automated flow cytometric analysis of<br />biological fluids. The results of 106 consecutive peritoneal samples and 20 pleural samples were compared with&#160;optical microscopy. A good agreement was found in total nucleated cells (TNC) count between Sysmex XE-2100 and&#160;manual microscopy (y=0.98x+3.2, r=0.99; mean bias, -9.5 TNC/&#956;L). The percentage of cells with high fluorescence&#160;in XE-2100 correlated with that of macrophages and mesothelial cells at microscopy (r=0.67; P &lt;0.001). The CV of&#160;TNC determination on XE-2100 ranged between 1.6% and 11.7%. At the 20% CV, the analytical sensitivity of XE-2100 was 29/&#956;L for TNC, 50/&#956;L for polymorphonuclear leukocytes (PMN) and 66/&#956;L for mononuclear elements. The&#160;linearity between 30 and 944 TNC/&#956;L was excellent (r=0.998, P &lt;0.001), whereas the carry-over was &lt;1%. At&#160;thresholds of &#8805;250 PMN/&#956;L in peritoneal fluid and &#8805;50% PMN or &#8805;50% lymphocytes in pleural fluid, the diagnostic&#160;accuracy of XE-2100 was 96.8%, with Cohen's kappa of 0.90 (P &lt;0.001). We conclude that automated flow&#160;cytometric analysis on Sysmex XE-2100 may be a viable options for screening of peritoneal and pleural fluids.</p>
Biochimica Clinica ; 37(4) 275-278
Contributi Scientifici - Scientific Papers