TY - JOUR
T1 - ICSH recommendations for identification, diagnostic value, and quantitation of schistocytes
AU - Zini Tanzi, Gina
AU - Briggs, C.
AU - Erber, W.
AU - Jou, J. M.
AU - Lee, S. H.
AU - Mcfadden, S.
AU - Vives-Corrons, J. L.
AU - Yutaka, N.
AU - Lesesve, J. F.
AU - D'Onofrio, Giuseppe
PY - 2012
Y1 - 2012
N2 - Schistocytes are fragments of red blood cells (RBCs) produced by extrinsic mechanical damage within the circulation. The detection of schistocytes is an important morphological clue to the diagnosis of thrombotic microangiopathic anemia (TMA). Reporting criteria between different laboratories, however, are not uniform, owing to variability of shape and nature of fragments, as well as subjectivity and heterogeneity in their morphological assessment. Lack of standardization may lead to inconsistency or misdiagnosis, thereby affecting treatment and clinical outcome. The Schistocyte Working Group of the International Council for Standardization in Haematology (ICSH) has prepared specific recommendations to standardize schistocyte identification, enumeration, and reporting. They deal with the type of smear, method of counting, morphological description based on positive criteria (helmet cells, small, irregular triangular, or crescent-shaped cells, pointed projections, and lack of central pallor). A schistocyte count has a definite clinical value for the diagnosis of TMA in the absence of additional severe red cell shape abnormalities, with a confident threshold value of 1%. Automated counting of RBC fragments is also recommended by the ICSH Working Group as a useful complement to the microscope, according to the high predictive value of negative results, but worthy of further research and with limits in quantitation.
AB - Schistocytes are fragments of red blood cells (RBCs) produced by extrinsic mechanical damage within the circulation. The detection of schistocytes is an important morphological clue to the diagnosis of thrombotic microangiopathic anemia (TMA). Reporting criteria between different laboratories, however, are not uniform, owing to variability of shape and nature of fragments, as well as subjectivity and heterogeneity in their morphological assessment. Lack of standardization may lead to inconsistency or misdiagnosis, thereby affecting treatment and clinical outcome. The Schistocyte Working Group of the International Council for Standardization in Haematology (ICSH) has prepared specific recommendations to standardize schistocyte identification, enumeration, and reporting. They deal with the type of smear, method of counting, morphological description based on positive criteria (helmet cells, small, irregular triangular, or crescent-shaped cells, pointed projections, and lack of central pallor). A schistocyte count has a definite clinical value for the diagnosis of TMA in the absence of additional severe red cell shape abnormalities, with a confident threshold value of 1%. Automated counting of RBC fragments is also recommended by the ICSH Working Group as a useful complement to the microscope, according to the high predictive value of negative results, but worthy of further research and with limits in quantitation.
KW - Erythrocyte Count
KW - Erythrocytes, Abnormal
KW - Humans
KW - Purpura, Thrombotic Thrombocytopenic
KW - Erythrocyte Count
KW - Erythrocytes, Abnormal
KW - Humans
KW - Purpura, Thrombotic Thrombocytopenic
UR - http://hdl.handle.net/10807/41052
U2 - 10.1111/j.1751-553X.2011.01380.x
DO - 10.1111/j.1751-553X.2011.01380.x
M3 - Article
SN - 1751-553X
VL - 34
SP - 107
EP - 116
JO - International Journal of Laboratory Hematology
JF - International Journal of Laboratory Hematology
ER -