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New parameters available on Sysmex XE ‐5000 hematology analyzers contribute to differentiating dengue from leptospirosis and enteric fever
Author(s) -
Oehadian A.,
Michels M.,
Mast Q.,
Prihatni D.,
Puspita M.,
Hartantri Y.,
Sinarta S.,
Ven A. J. A. M.,
Alisjahbana B.
Publication year - 2015
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12422
Subject(s) - dengue fever , leptospirosis , medicine , hematology analyzer , hematology , dengue virus , gastroenterology , immunology , virology
Summary Introduction Distinguishing dengue virus infection from other febrile thrombocytopenic illnesses such as leptospirosis or enteric fever is important but difficult, due to the unavailability of reliable diagnostic tests. Sysmex XE ‐5000 hematology analyzers use fluorescence flow cytometry to quantitate new parameters including cells in the atypical lymphocyte area ( AL ), high‐fluorescent lymphocyte counts ( HFLC ), immature granulocytes ( IG ), and immature platelets ( IPF ). This study aimed to investigate whether these parameters can help to discriminate between the diseases. Material and methods We compared hematocytometry performed by a Sysmex XE ‐5000 analyzer in Indonesian adults with dengue ( n = 93), leptospirosis ( n = 11), and enteric fever ( n = 6) infection, and in healthy controls ( n = 28). Results Receiver operating characteristic curves comparing dengue and leptospirosis showed that dengue was characterized by increased % AL ( AUC 0.87; 95% CI 0.70–1.03), % HFLC ( AUC 0.89; 95% CI 0.78–0.99), and % IPF ( AUC 0.81; 95% CI 0.65–0.97), while patients with leptospirosis had increased % IG ( AUC 0.86; 95% CI 0.71–1.02). Low % AL , % HFLC , and % IG supported a diagnosis of enteric fever. Conclusions The detection of AL , HFLC , IG , and IPF by Sysmex XE ‐5000 hematology analyzers can help to differentiate between common causes of febrile illnesses with thrombocytopenia in dengue endemic areas. We recommend further investigating the discriminatory value of these parameters in clinical practice.