Page 2620 - Hematology_ Basic Principles and Practice ( PDFDrive )

C H A P T E R 162

RESOURCES FOR THE HEMATOLOGIST: INTERPRETIVE

COMMENTS AND SELECTED REFERENCE VALUES FOR

NEONATAL, PEDIATRIC, AND ADULT POPULATIONS

Andrea N. Marcogliese and Donald L. Yee*

APPENDIX CONTENTS This appendix is intended to provide useful supplemental informa-
tion to clinicians in selecting, obtaining, and interpreting certain key
RED BLOOD CELL TESTING laboratory tests relevant to hematology. The most appropriate refer-
• Estimated Blood Volumes (Plasma Volume and Red Blood ence range for a particular test is dependent on the specific testing
Cell Mass) methods employed (including reagents and instrumentation), patient
• Complete Blood Count (Red Blood Cell) Parameters age and gender, testing conditions, preanalytical variables, and other
• Red Blood Cell Distribution Width concurrent medical conditions. The listed reference ranges thus
• Reticulocyte Count (Absolute and Percentage) provide only a rough guide to differentiating normal from abnormal
• Immature Reticulocyte Fraction results. Clinicians are encouraged to seek out the most applicable and
• Reticulocyte Hemoglobin Equivalent appropriate reference range for a particular test, preferably using refer-
• Haptoglobin ence data that are specific to the performing laboratory and the
• Hemoglobin F and Hemoglobin A2 patient population being tested. Although the tables listed herein
• Sickle Cell Screen (Hemoglobin S Solubility Test) provide some age-specific information, caution is particularly empha-
• Ferritin sized in interpreting results obtained from testing infants and
• Total Iron-Binding Capacity, Transferrin Saturation children.
• Iron
• Erythropoietin
• Folate (RBC or Serum/Plasma) Estimated Blood Volumes (Includes Plasma
• Vitamin B 12 (Cobalamin) Volume, Red Blood Cell Mass)
• Homocysteine
• Methylmalonic Acid The red cell volume, plasma volume, and total blood volume are
• Osmotic Fragility calculated from hematocrit (packed cell volume) and isotope dilution
• Red Cell Glycolytic Intermediate Metabolites in Normal after reinjection of red cells labeled with a radioactive isotope. Per-
Adults, Term Infants, and Premature Infants formance of a red cell mass determination is occasionally indicated
WHITE BLOOD CELL AND IMMUNOLOGIC TESTING in the investigation of polycythemia to differentiate primary or sec-
• Leukocyte Counts (Absolute and Percentage) ondary polycythemia (elevated red cell mass) from relative polycythe-
• Lymphocyte Subsets mia (normal red cell mass). Table 162.1 provides typical reference
• Immunoglobulin A ranges.
• Immunoglobulin E Total blood volume can also be estimated by calculation†:
• Immunoglobulin G
• Immunoglobulin G Subclasses Total Blood Volume for Males =[ .3669 ×( Height in Meters) ]
3
0
• Immunoglobulin M +[ .0 03219 × (Weight in Kilograms )] 0 .6041 ;
+
[
• Immunoglobulin Light Chains
3
• Complement Fractions C3 and C4 Total Blood Volume for Females =[ .3561 ×( Height in Meters) ]
0

0
t
PLATELET AND COAGULATION TESTING +[ .03308 ×( Weight in Kilograms)]+ 0 .1833 .
• Platelet Count and Mean Platelet Volume
• Immature Platelet Fraction
• Coagulation Screening Tests (PT, aPTT, Fibrinogen)
• Coagulation Factor Levels (Fibrinogen, II, V, VII, VIII, von
Willebrand Factor, IX, X, XI, Contact Pathway Factors)
• Natural Anticoagulants (Antithrombin, Protein C, Protein S,
Tissue Factor Pathway Inhibitor) *Previously collated by Donald L. Yee, Catherine M. Bollard, and Sharon M.
• D-dimer Geaghan.
• PFA-100 †From Nadler SB, Hidalgo JU, Bloch T: Prediction of blood volume in normal
• Platelet aggregometry human adults. Surgery 51:224, 1962.

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