Hematology

Initial evaluation of patients with lymphocytosis

In adults, lymphocytosis is considered to be an absolute lymphocyte count greater than 4x109/L, and in children up to 10 years of age, greater than 7x109/L.

To assess lymphocytosis, it is necessary to take into account patient's age, clinical history, time of onset and evolution of lymphocytosis, physical examination (lymph node areas, liver, spleen), laboratory parameters and morphological findings of lymphocytes.

Causes can be divided into 2 large groups: reactive lymphocytosis and clonal lymphocytosis or lymphoproliferative syndromes.

Below, we will summarize lymphopoiesis, discuss following steps in the initial study of patients and list the main causes,while describing morphological findings found in the review of the smear. In addition, we will explain the Catlab work methodology for the study of this frequent alteration.

HEMATOLOGY-Detection of Hemoglobin variants in glycated Hemoglobin(HbA1c) studies in pregnant women

As a result of the Covid-19 pandemic,as a measure to reduce contagion, gestational diabetes detection protocols have been implemented. O'Sullivan test and Glucose curve have been replaced (they imply a extended stay in healthcare facilities) for HbA1c and Glucose.

At Catlab, HbA1c is determined by HPLC. Separation method that allows detecting most fractions of Hemoglobin present in the sample. If suspicious peaks are found, the study is extended using another HPLC analyzer and electrophoresis.

HEMATOLOGY - Diagnosis of von Willebrand disease

Von Willebrand disease is the most common inherited bleeding disorder (1 case per 10,000 inhabitants) and is characterized by defective platelet adhesion and aggregation, with mucosal associated bleeding and after surgery and trauma. The diagnosis is based on a personal or family history of bleeding, and abnormal laboratory tests of von Willebrand Factor, Factor VIII or both. In Catlab the basic coagulation tests are performed, and the first level tests for the diagnosis of von Willebrand disease; FVIII, FvW:Ag, FvW:RCo.

HEMATOLOGY - Graphic reports in the studies of Hemoglobinopathies

Since this month of January, can be seen in the studies of hemoglobinopathies

(hemoglobins A2 and F, electrophoresis), in addition to the percentage of variant hemoglobin and the numerical result, a graphic report with the chromatograms by HPLC (high efficiency liquid chromatography), and the scanned images of the alkaline electrophoresis plate if it has been carried out this technique. The objective is to provide a more detailed result, and facilitate its interpretation.

HEMATOLOGY - Quantification of Hemoglobin S in Catlab

Hemoglobin S is a beta-globin variant. It is a hereditary pathology and can be present in heterozygous and homozygous form, as well as combined with other mutations. The homozygous form is the most severe, and as a treatment, patients require frequent transfusions. In Catlab, Hemoglobin S can be quantified by two main methods: HPLC and electrophoresis.

HEMATOLOGY - The lupus anticoagulant in Catlab

The Lupus anticoagulant is a coagulation test in which the presence of antibodies that may interfere with phospholipid coagulation reactions and which are a risk factor for thromboembolic diseases. Through the study of the results of lupus Anticoagulants performed at Catlab, we have reached a series of conclusions and recommendations for its request.

HEMATOLOGY - Haemoglobinopathies studies

Review of the various alterations of hemoglobin and the different methods used to detect them in Catlab. Structural haemoglobinopathies are classified by the disturbance affecting the solubility, stability, affinity for oxygen or maintenance of the reduced iron. The thalassemias are classified according to the globin chain stops synthesized, and we also have the thalassemic haemoglobinopathies, which are mutations in the globin genes that cause structural problems.

HEMATOLOGY – Orientation in the study of Microcytosis
According to the WHO, concentrations of Hb < 12 mg/dL in women and < 13 mg/dL in men, is considered anemia, and Microcytosis if the VCM is lower than 80 fL. What do these figures mean in the day-to-day life of the Laboratory?

HEMATOLOGY - Coagulation studies in Catlab

In Catlab, are performed daily basic studies and special tests are grouped into profiles.

HEMATOLOGY - New units and reference values ​​for HbA1c

HbA1c is currently the benchmark for assessing control of diabetes and can make used different calibration standards, and therefore with slightly different results (IFCC, JDS; DCCT / NGSP).