The frequency of occurrence of fish-shaped red blood cells in different haematologic disorders.

Background: Red blood cells (RBC) resembling the silhouette of a fish are rarely observed in peripheral blood (PB) smears. In this study, we determined the frequency of occurrence of fish-shaped RBC in different haematologic diseases.

Methods: We examined PB smears of patients with iron deficiency anaemia (IDA) (n=23), β-thalassaemia minor (BTM) (n=30), sickle cell disease (SCD) (n=7), autoimmune haemolytic anaemia (AIHA) (n=13), microangiopathic haemolytic anaemia (MAHA) (n=11), hereditary sphaerocytosis (HS) (n=4), hereditary elliptocytosis (HE) (n=3), vitamin B12 and folate deficiency (n=15), anaemia in liver disease (LD) (n=17), myelodysplastic syndrome (MDS) (n=15), acute myeloid leukaemia (AML) (n=29), chronic myeloid leukaemia (CML) (n=18), primary myelofibrosis (PMF) (n=12), chronic myelo-monocytic leukaemia (CMML) (n=15) and 21 healthy controls by light microscopy for the occurrence of fish-shaped erythrocytes.

Dacryocytes are a common morphologic feature of autoimmune and microangiopathic haemolytic anaemia.

Background: Dacryocytes are teardrop-shaped erythrocytes which are most frequently observed in peripheral blood smears of patients with primary or secondary myelofibrosis as well as malignant infiltrative disorders of the bone marrow. Dacryocytes have rarely been described in blood smears of patients with autoimmune (AIHA) and microangiopathic haemolytic anaemia (MAHA). The clear prevalence of dacryocytes in AIHA and MAHA is unknown.

Cytospin preparations are superior to common smears in the detection of monosodium urate crystals in low-cellular synovial fluids.

In cases of gout with a low synovial fluid (SF) leukocyte count and atypical clinical presentation, such as in intercritical periods, the load of monosodium urate (MSU) crystals is frequently low, and thus, methods to improve the crystal detection may be beneficial. We compared the MSU crystal detection rates between cytospin slides and common smear preparations in low-cellular (<2,000/μl) SF samples of patients with gout. We determined the number of MSU crystals/15 high power fields (HPF) at × 1,000 magnification by polarised microscopy in cytospin preparations and smears in SF samples of 17 patients with MSU-crystal-proven gout and compared the two methods statistically.

The anti-VLA-4 antibody natalizumab induces erythroblastaemia in the majority of the treated patients with multiple sclerosis.

The presence of erythroblasts in the peripheral blood is generally associated with severe underlying disorders. The anti-very late antigen-4 (anti-VLA-4) antibody natalizumab, which is approved for treatment of multiple sclerosis, mediates an increase in circulating haematopoietic stem cells and may also trigger erythroblastaemia. We investigated the prevalence of erythroblastaemia in sequential blood smears of 14 natalizumab-treated and 14 interferon-treated patients with multiple sclerosis.

Assessment of the response to acetylsalicylic acid in patients with myeloproliferative neoplasms by whole blood assays: a comparison of the PFA-100 with multiple electrode aggregometry.

Since thrombotic and haemorrhagic complications are the most important causes of morbidity and mortality in myeloproliferative neoplasms (MPN), establishing valid techniques for the monitoring of antiaggregatory treatment would be beneficial. The aim of this study was to assess the aspirin responsiveness in patients with MPN by multiple electrode aggregometry (MEA) and the PFA-100, to determine the concordance rate between the two techniques and to examine a potential clinical impact. Twenty-two consecutive outpatients with polycythaemia vera and essential thrombocythaemia receiving long-time treatment with 100 mg of aspirin were included and clinically re-evaluated within six months after study entry.

Changes in response to antiaggregatory treatment in patients with myeloproliferative neoplasms: a sequential study using multiple electrode aggregometry.

In the present study, we used multiple electrode aggregometry (MEA) to investigate the response to aspirin and clopidogrel treatment, and its potential changes over a long-time disease course in patients with myeloproliferative neoplasms (MPNs). arachidonic acid (ASPI), ADP, and thrombin receptor activating peptide (TRAP) tests were performed at two timepoints between 32-50 months in 21 patients with MPN and 1-46 months in 29 controls. We further checked the medical records of the participants to identify a potential correlation of changes in the treatment response with clinical events.

The cytospin technique improves the detection of calcium pyrophosphate crystals in synovial fluid samples with a low leukocyte count.

In synovial fluids (SF) with low leukocyte or/and crystal counts, important features may be missed, if exclusively smears are examined by polarized microscopy. That may be overcome by cytocentrifuges, which use low-speed centrifugal force to concentrate cells onto a glass slide and thus enhance the number of cells per high power field (HPF). We compared the calcium pyrophosphate (CPP) crystal counts in cytospin preparations with those in common smears of SF.

The detection of calcium pyrophosphate crystals in sequential synovial fluid examinations of patients with osteoarthritis: once positive, always positive.

The aim of this study was to investigate whether calcium pyrophosphate dihydrate (CPPD) crystals are constantly detectable in sequential synovial fluid (SF) examinations of patients with initially CPPD-positive osteoarthritis (OA). For this purpose, we searched our SF database for CPPD-positive patients, who had two or more SF analyses between 2008 and 2012 to get sequential information. The database contains SF data determined by a standardised procedure.

The detection of calcium pyrophosphate crystals in the synovial fluid of patients with rheumatoid arthritis using the cytospin technique: prevalence and clinical correlation.

There are only a few studies dealing with the detection and clinical impact of calcium pyrophosphate (CPPD) crystals in patients with rheumatoid arthritis (RA) published to date. In particular, data determined by the cytospin technique, which is an effective tool to enhance the crystal detection rate, are lacking. The objectives of this study were to determine the prevalence of CPPD crystals in the synovial fluid (SF) of patients with RA and to investigate whether the detection of CPPD crystals is correlated with demographic, clinical and serological features.

Dried cytospin preparations of synovial fluid are a stable material for long-time storage and delayed crystal analysis.

The aim of this study was to evaluate dried SF cytospin preparations as a suitable medium for long-time storage and delayed crystal analysis. For this purpose, we analyzed ten MSU-positive, ten CPPD-positive and 20 crystal-negative SF at baseline (wet preparation), after 24 h, 1 week, 4 weeks, 6 months and 12 months for the occurrence of crystals. After cytocentrifugation for 10 min at 700 rpm in a Shandon Cytospin 4 cytocentrifuge (Thermo Fisher Scientific, Waltham, USA), the sediments were dried on the slides and examined in blinded fashion at any time point by an experienced analyst using polarized microscopy.

Pseudoeosinophilia of synovial fluid is caused by crystals mimicking the distinct light scattering fractions of eosinophilic granules.

Background: Automated leukocyte differential counts of synovial fluid (SF) can be influenced by laboratory artefacts. Pseudoeosinophilia of SF has recently been first described in association with monosodium urate and calcium pyrophosphate crystals. This study compared automated measurements of the percentages of SF leukocyte fractions by two haematology analysers in order to elucidate the underlying mechanism of pseudoeosinophilia.

Calcium pyrophosphate and monosodium urate crystals in synovial fluid as a cause of pseudoeosinophilia.

Background: Synovial fluid (SF) leukocytes can be counted microscopically in a Neubauer chamber or by automated procedures using haematology analysers. Knowledge of laboratory artefacts is crucial for the correct interpretation of results obtained using automated methods. SF pseudoeosinophilia has recently been described as a new artefact in patients with crystal-related arthropathies.

Evaluation of platelet function and pharmacological platelet inhibition in patients with myeloproliferative disorders using multiple electrode aggregometry.

Background: The aim of this study was to describe platelet aggregation characteristics by multiple electrode aggregometry (MEA) and to evaluate MEA for its potential to detect platelet dysfunction and response to anti-aggregatory drugs in patients with myeloproliferative disorders (MPD).

Methods: We compared the platelet response to arachidonic acid (ASPI test), adenosine diphosphate (ADP test) and thrombin receptor activating peptide (TRAP test) in hirudin-anticoagulated blood of 55 patients with polycythaemia vera and essential thrombocythaemia and 75 controls.

Results: Comparing MPD patients and controls no statistically significant difference indicative of platelet dysfunction was found in MPD patients.