Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells
Scintigraphy with indium-labeled white blood cells has been reported to be sensitive and specific in the diagnosis of low-grade sepsis of the musculoskeletal system. We reviewed the records of fifty patients who had suspected osteomyelitis or suspected infection about a total joint prosthesis and who underwent scintigraphy with technetium-99m methylene diphosphonate and scintigraphy with indium-111 oxine-labeled white blood cells before an open surgical procedure. Any patient who received preoperative antibiotics was not included in the study. For all of the patients, gram-stain examination of smears, evaluation of a culture of material from the operative site, and histological examination were done. The patients were divided into two groups. Group I was composed of twenty-four patients, each of whom had a prosthesis in place and complained of pain. Group II was composed of twenty-six patients for whom a diagnosis of chronic osteomyelitis had to be considered. With the indium scans alone, there was only one false-negative result (in Group II), but there were eighteen false-positive results (eight patients in Group II and ten patients in Group I). Although scintigraphy with indium-labeled white blood cells is quite sensitive, it is not specific in detecting chronic osteomyelitis; a negative scan should be considered highly suggestive that osteomyelitis is not present. Specificity can be increased by interpreting the indium scan in conjunction with the technetium scan. [1]
Histological study of white blood cells and their association with lipodermatosclerosis and venous ulceration
The number of white blood cells per mm2 has been determined in serial histological slides taken from punch biopsies of skin from the gaiter region in patients with varicose veins. In eight patients the varicose veins were complicated by lipodermatosclerosis of the skin, and in a further six there was a history of ulceration. In uncomplicated varicose veins there was a median of 6 white blood cells per nm2, in patients with lipodermatosclerosis there were 45 white blood cells per mm2, and where there was a history of ulceration, 217 white blood cells per mm2. No change in white blood cell content was observed after the venous pressure was raised for 30 min by sitting the patient with the lower limb dependent. White blood cell infiltration of the skin is associated with lipodermatosclerotic changes caused by venous insufficiency. [2]
Comparison of methods to enumerate white blood cells in semen
Seminal WBC counts obtained by an mAb-based immunohistologic method correlated well with seminal granulocyte counts obtained with a simple peroxidase method (rho = +0.70; P < 0.0001). However, total WBC counts were significantly higher than granulocyte counts for most samples. With the immunohistologic method, 17 of 112 samples (15.2%) contained > 10(6) WBC/mL semen, whereas the peroxidase method resulted in only 10 samples (8.9%) with > 10(6) WBC/mL. When the threshold defining leukocytospermia was set at 1 x 10(6) positive cells/mL for both methods, the specificity of the peroxidase test compared with the immunohistology technique was 100% (10/10), but the sensitivity was only 58.8% (10/17). When the threshold for leukocytospermia in the peroxidase test was lowered to 5 x 10(5) positive cells/mL semen, the sensitivity relative to the immunohistology technique increased to 94.1% (16/17), and specificity remained 100% (16/16). Likewise, good interassay sensitivity and specificity values were obtained with thresholds of 10(6) WBC/mL for the peroxidase assay and 2 x 10(6) WBC/mL for the immunohistology assay. We conclude that either peroxidase or immunohistology assays can be used to screen for leukocytospermia, but that more research is needed to establish thresholds for pathological levels of WBC in semen using these two approaches. Total round cell counts are of no value for enumerating WBC in semen. [3]
Determination of Platelet and White Blood Cell Counts from Peripheral Blood Smear: An Indispensable Method in Under-resourced Laboratories
Objective: Blood smear examination serves as a quality control tool in verifying the results generated by the automated analyzer and identification of abnormal or immature cells amongst other functions. This study was undertaken to estimate platelet and White Blood Cell (WBC) counts from Peripheral Blood Smear (PBS) and to correlate them with the results from automated method.
Materials and Methods: Fifty blood samples collected into K3 EDTA from 30 males and 20 females whose ages were from 2 to 50 years, and attended General Out-Patient Department (GOPD) of Aminu Kano Teaching Hospital, Kano between May and November, 2015 were considered for the study. Each blood sample was used for the determination of full blood count using Swelab Alfa hematology analyzer, and preparation of stained blood films using standard laboratory methods.
Results: There were significantly lower values of platelet count (using multiplication factor of 15.0 x109/L) and white blood cell count (using multiplication factor of 2.0 x109/L) to derive (22.42±60.77) x109/L and (4.49±1.04) x109/L by manual (PBS) method as compared to (267.86±77.28) x 109/L and (5.86±1.36) x109/L respectively, for automated method (P<0.001). However, there was no significant difference in estimated platelet count by manual (PBS) method using multiplication factor of 20.0 x109/L compared to automated method (P>0.05). Fairly strong positive correlations were observed for platelet and white blood cell counts when manual method was compared to automated method (r= 0.6828 – 0.7321, P<0.05).
Conclusion: It can be concluded that multiplications factors of 20.0 x109/L per 100X, objective lens and 2.7 x109/L per 40X, objective lens can be used for average numbers of platelets and white blood cells respectively to estimate platelet and white blood cell counts from PBS as the results are comparable to that of the hematology analyzer. [4]
Changes in White Blood Cells Differential Associated with Adult Malaria-Infected Patients
Aims: Malaria parasites are expected to impact the white blood cell differential of malaria patients, but reports on changes in white blood cell differentials of malaria patients are not well documented, hence this study was undertaken to determine changes in white blood cell differentials associated with male and female malaria patients.
Study Design: Twenty male and twenty female malaria patients were divided into four groups made up of ten malaria positive males (MPM), ten malaria negative males (MNM), ten malaria positive females (MPF) and ten malaria negative females (MNF).
Methodology: The hematological parameters were evaluated using automated full blood count Sysmex machine.
Results: The result of changes in white blood cell differential associated with male and female malaria patients showed an increase in lymphocyte percentage (LYM%), mixed cell count percentage (MXD%), neutrophil percentage (NEU%), lymphocyte absolute value (LYM#), mixed cell count absolute value (MXD#) and neutrophil absolute value (NEU#) of both malaria positive males and females compared to malaria negative males and females which were statistically significant (P < 0.05).
Conclusion: This study has shown that malaria parasite increased all white blood cell differential parameters significantly in male and female patients examined. White blood cell differential in adult malaria-infected patients are associated with an increase in white blood cell differential parameters irrespective of gender. Further studies should be carried out to determine the clinical relevance of this finding especially as it could assist in the diagnosis of malaria infection. [5]
Reference
[1] Wukich, D.K., Abreu, S.H., Callaghan, J.J., Van, D.N., Savory, C.G., Eggli, D.F., Garcia, J.E. and Berrey, B.H., 1987. Diagnosis of infection by preoperative scintigraphy with indium-labeled white blood cells. The Journal of bone and joint surgery. American volume, 69(9), pp.1353-1360.
[2] Scott, H.J., Coleridge Smith, P.D. and Scurr, J.H., 1991. Histological study of white blood cells and their association with lipodermatosclerosis and venous ulceration. British journal of surgery, 78(2), pp.210-211.
[3] Politch, J.A., Wolff, H., Hill, J.A. and Anderson, D.J., 1993. Comparison of methods to enumerate white blood cells in semen. Fertility and sterility, 60(2), pp.372-375.
[4] Momodu, I. (2016) “Determination of Platelet and White Blood Cell Counts from Peripheral Blood Smear: An Indispensable Method in Under-resourced Laboratories”, International Blood Research & Reviews, 5(2), pp. 1-7. doi: 10.9734/IBRR/2016/25105.
[5] C. Ozougwu, J. (2018) “Changes in White Blood Cells Differential Associated with Adult Malaria-Infected Patients”, Journal of Advances in Medical and Pharmaceutical Sciences, 16(1), pp. 1-5. doi: 10.9734/JAMPS/2018/38784.
