Practical Approach to the Interpretation of Complete Blood Count Reports and Histograms

Improvement in technology and inclusion of new parameters in automated hematology analyzers allows for better and faster detection of anemias. These parameters along with histograms provide details and clues that help to diagnose the etiology of anemia and help bridge the time lag in detection and treatment. Timely and expert interpretation of complete blood counts should not be limited to the pathologist but should also interest the clinician to allow for efficient patient care.

Serum Interleukin-6 Levels in Children with Febrile Seizures

Objectives: To compare levels of Interleukin-6 (IL-6) in children with febrile seizures andfebrile controls. Methods: Study conducted in a tertiary-care hospital in Northern India fromNovember 2013 to April 2015, enrolling 160 children (80 each with febrile seizures and febrilecontrols), aged 6 – 60 months. Serum IL-6 estimated by ELISA method. Iron study done asper standard technique. All the cases of febrile seizure were followed up at 1 week, 3 monthsand 6 months for recurrence of seizures. Results: The mean serum IL-6 levels in childrenwith febrile seizures was 62.0 (63.9) pg/mL and febrile controls was 86.9 (70.6) pg/mL(P=0.025). Conclusion: Serum IL-6 levels were significantly lower in children with febrileseizures as compared to febrile controls.

Celiac Disease in Children with Moderate-to-Severe Iron-deficiency Anemia

Objective: To evaluate the proportion of children with moderate to severe iron-deficiencyanemia who have associated celiac disease. Methods: This cross-sectional analytical studywas conducted among children aged 1 to 12 years of age with moderate-to-severe irondeficiency anemia and control children without anemia.Serum IgA-tissue trans-glutaminaselevels were assessed in both cases and controls. All children with positive celiac serologyunderwent upper gastrointestinal endoscopy and duodenal biopsy; biopsy finding of Marshgrade 3 was considered positive for celiac disease. Results: There were 152 anemic childrenand 152 controls with mean (SD) hemoglobinof 7.7 (1.8) and 12.2 (0.74) g/dL, respectively.16 (10.5%) cases and 3 (2%) control patients had positive serology for celiac disease [OR(95% CI) 5.33 (1.52-18.67), P=0.007]. Six (3.9%) children with iron-deficiency anemia andnone of the controls had biopsy features diagnostic of celiac disease. Conclusion:In theNorthern Indian tertiary-care hospital outpatient setting, Celiac disease was associated with4% of children presenting with moderate-to-severe anemia.

Transient thrombocytosis with megathrombocytes in a case of acute myeloblastic leukemia.

Thrombocytosis is commonly seen in reactive conditions and certain neoplastic states, such as chronic myeloproliferative disorders. It is rarely seen in acute leukemia. A 12-year-old girl with acute myeloblastic leukemia (FAB M2) in remission presented with pyoderma. Her hemogram revealed anemia (Hb-6.4g/dl), leucopenia (TLC - 1.2 x 109/L) and thrombocytosis (platelet count- 580 x 109/L). A peripheral blood film showed numerous abnormally large platelets with few atypical cells. The thrombocytosis subsided with the clearance of infection but atypical cells persisted. One month later, she relapsed. Cytogenetic analysis revealed variable results (trisomy 9 and deletion 3). This case has been presented because thrombocytosis is rare in AML and its appearance calls for a close follow-up.

Prevalence of HIV and VDRL seropositivity in blood donors of Delhi.

Blood transfusion has been the transmission mechanism in 15 per cent of total patients infected with human immunodeficiency virus (HIV). A few reports are available regarding the trend of HIV seropositivity in northern India. Prevalence of VDRL (venereal disease research laboratory) reactivity varies from 0.8-15 per cent in blood donors. We present data on the prevalence and trends of infection with HIV 1 and 2 and VDRL reactivity in blood donors in Delhi. Between 2000-2002, a total of 76089 (voluntary and replacement) donors were screened. Majority (82.4%) were replacement donors. Seropositivity for HIV and VDRL was seen in 0.54 and 2.6 per cent of donors respectively. The percentage of seropositivity for HIV and VDRL was significantly higher in replacement donors (P<0.001). It is suggested that extensive donor selection and a voluntary donor service would reduce the number of infectious donors significantly. Non-renumerated repeat voluntary donor services are urgently required to lower the prevalence of transmissible infections. While the need to change to a voluntary donor service and devising effective donor screening cannot be over emphasized, there is also a need to mandate HIV antigen detection in India.

Unicystic granulosa cell tumor: a case report.

Granulosa Cell Tumors (GCT) constitutes 1.5% to 3.5% of all primary ovarian neoplasms. They may be solid, cystic or both. Unilocular cystic GCT are very rare. We report here a case of 32 years female with unicystic GCT in which the distinction from follicular cyst was difficult and was made by carefully examining the lining of the cyst,which showed occasional multiple layers of granulosa cells with a few Call-Exner bodies.