is peripheral blood smear examination an obsolete art

Research Article
Swaroop Raj B V*, Sunita B S, VanmaliniTewari and Divya C
DOI: 
xxx-xxxx-xxx
Subject: 
science
KeyWords: 
Morphological Typing of anemia; Red cell Distribution Width; XT- 2000i, automated hematology analyzer; Peripheral blood smear examination.
Abstract: 

AIMS - Globally, anemia affects 1.62 billion people, which corresponds to 24.8% of the population. Once anemia is established, a morphological typing of anemia helps the clinician to approach the cause of anemia. The automated hematology analyzers give accurate and <1% coefficient of variation for the RBC indices and hence have replaced the manual methods. The expertise needed to see the peripheral blood smear is definitely far more than that needed to run the analyzers. The additional peripheral blood smear review performed by hematologist hardly ever provided unique information and provided incremental helpful information in only 4% of the cases. A total of 600 cases of anemia were studied over a period of two years. Anemia typing was done by using RBC indices with RDW and then with additional peripheral blood smears examination followed by correlation of results. Morphological typing of anemia in cases of Microcytic hypochromic anemia, Normocytic Normochromic anemia with normal RDW and Macrocytic anemia using RBC indices and RDW from XT-2000i, an automated hematology analyzer showed very high specificity and high sensitivity. However cases with raised RDW were wrongly typed on indices alone and had a low sensitivity and specificity indicating additional peripheral blood smear examination was essential in such cases.