PMID- 9202619
OWN - NLM
STAT- MEDLINE
DCOM- 19970717
LR  - 20220317
IS  - 0022-3476 (Print)
IS  - 0022-3476 (Linking)
VI  - 130
IP  - 6
DP  - 1997 Jun
TI  - Screening for hereditary spherocytosis by use of automated erythrocyte indexes.
PG  - 957-60
AB  - OBJECTIVE: To determine whether the mean corpuscular hemoglobin concentration 
      (MCHC) or other erythrocyte indexes, as determined by automated cell counters, 
      remains a useful screening test for identifying patients with hereditary 
      spherocytosis (HS). METHODS: Erythrocyte indexes from 112 children with HS who 
      had not undergone splenectomy were compared with those measured in an equal 
      number of healthy, age-matched children. All indexes were derived from 
      measurements obtained by aperture impedance. RESULTS: Mean corpuscular hemoglobin 
      concentration in the HS group was 35.9 gm/dl, significantly higher than in normal 
      control subjects (34.3 gm/dl; p < 0.001). Mean erythrocyte distribution width 
      also was significantly higher in patients with HS (19.3 vs 12.6; p < 0.001). The 
      MCHC distinguishes individuals with HS, with an area under the receiver operating 
      characteristic curve of 0.86. Although not disease specific, an erythrocyte 
      distribution width > 14 has 85% sensitivity and 97% specificity and an area under 
      the receiver operating characteristic curve of 0.92. An MCHC > 35 gm/dl has a 
      sensitivity of 70% and a specificity of 86%. Combining the MCHC and erythrocyte 
      distribution width increases the area under the receiver operating characteristic 
      curve to 0.97. Specificity is 100% and likelihood ratio is infinite when both the 
      MCHC and erythrocyte distribution width are elevated. CONCLUSIONS: The automated 
      MCHC is an effective screening test to identify children with HS. An elevated 
      erythrocyte distribution width adds additional specificity and is itself a 
      powerful screening tool. The combination of the two tests is an excellent 
      predictor for the diagnosis of HS.
FAU - Michaels, L A
AU  - Michaels LA
AD  - Division of Hematology, Children's Hospital of Philadelphia, Pennsylvania 19104, 
      USA.
FAU - Cohen, A R
AU  - Cohen AR
FAU - Zhao, H
AU  - Zhao H
FAU - Raphael, R I
AU  - Raphael RI
FAU - Manno, C S
AU  - Manno CS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - *Erythrocyte Indices
MH  - Humans
MH  - Infant
MH  - Reticulocyte Count
MH  - Spherocytosis, Hereditary/*diagnosis
MH  - Splenectomy
EDAT- 1997/06/01 00:00
MHDA- 1997/06/01 00:01
CRDT- 1997/06/01 00:00
PHST- 1997/06/01 00:00 [pubmed]
PHST- 1997/06/01 00:01 [medline]
PHST- 1997/06/01 00:00 [entrez]
AID - S0022-3476(97)70283-X [pii]
AID - 10.1016/s0022-3476(97)70283-x [doi]
PST - ppublish
SO  - J Pediatr. 1997 Jun;130(6):957-60. doi: 10.1016/s0022-3476(97)70283-x.