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International Council for Standardization in Haematology (ICSH) recommendations for processing of blood samples for coagulation testing.

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  Dear friends,  Sorry, I could not post anything in the last 8 months.   Hoping to write regularly henceforth.  Thank you all for your support and wishes.  International Council for Standardization in Haematology (ICSH) establishes guidelines on various hematology laboratory tests and diseases to help the hematology community in having universal standards of laboratory tests and reporting. The ICSH recommendations for processing of coagulation testing has been published in August 2021. The article is freely downloadable from the website.  I have summed up the recommendations in this post and will continue the remaining in the next post.  Storage:  Recommendation 1: Whole blood samples for coagulation tests should be maintained at an ambient temperature of 18-24°C during transport and storage prior to processing. Pneumatic tube transport systems  Recommendation 2: Pneumatic tube transport systems should not be used to transport citrated blood samples prior to tests of platelet functi
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ICSH recommendations for microscopic identification of schistocytes

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  Schistocytes or schizocytes is derived from the greek word ‘schisto’ which means broken or cleft. They are circulating fragments of red blood cells (RBCs) or RBCs which have lost cytoplasmic fragments. Causes of Schistocytes: ü   They are usually absent or very rare in healthy individuals ü   Thrombotic microangiopathy ·          Thrombotic thrombocytopenic purpura ·          Hemolytic uremic syndrome ü     Malfunctioning prosthetic valve ü     HELLP syndrome ü   Malignant hypertension ü   Metastatic cancer v   The morphology of RBCs in peripheral smear is important. When schistocytes are seen in non-TMA related genetic or acquired RBC disorders, like Thalassemia, Primary Myelofibrosis, Megaloblastic anemia, thermal injuries, they show marked anisopoikilocytosis and a range of additional RBC size and morphological changes. Microscopic identification of schistocytes. According to ICSH, schistocytes are always smaller than intact RBCs (i)    small fragments o
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2021 update of the 2012 ICSH Recommendations for identification, diagnostic value, and quantitation of schistocytes: Impact and revision

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Hi friends, I am writing this post after a long time. Sorry about that. Hope you are all doing well.    The International Council for Standardization in Haematology (ICSH) published recommendations for the identification, quantitation, and diagnostic value of schistocytes in 2012.    What was the main focus of 2012 ICSH recommendations? Ø   Microscope evaluation method, Ø   Specific morphologic criteria for schistocyte Ø   Identification and percentage calculation, Ø   Definition of a threshold value in healthy subjects  Whats new in 2021 update ?  It is review of the effectiveness and clinical usefulness of the ICSH 2012 recommendations based on the published literature. Additional recommendations: ·          The study of preanalytical factors, ·          The context for reporting schistocyte percentage of clinical significance in the diagnosis of thrombotic microangiopathy (TMA) and transplant-associated TMA (TA-TMA), ·          Initial validation criteria for
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Shine the light on Sickle cell- Hydroxyurea in Sickle cell disease.

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  June 19 is observed as world Sickle cell disease     and celebrated globally to raise awareness about Sickle cell disease. The theme  is “Shine the light on Sickle cell”. In this post let me shine some light on “Hydroxyurea in Sickle cell disease”.  Properties Hydroxyurea   Drug class Antimetabolite  Mechanism of action  Inhibition of ribonucleotide reductase (RR)  Increases HbF production Pharmacology  Half-life :4 hours  Potential benefits  ·        Improved survival & increased life expectancy ·        Decreased venoocclusive pain  ·        Decreased Acute coronary syndrome episodes  ·        Decreased transfusions ·        Decreased priapism episodes  ·        Preserve splenic function in infants  ·        Improved quality of life and daily functioning    Beneficial  In HbSS or HBs/ Beta 0  thalassemia genotypes Standard indications – Can be given at any age  from 6 month old infants to adults ·         Frequent pain crises ·         Acute chest syndrome ·         Severe or s
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COVID 19: Vaccine induced immune thrombotic thrombocytopenia (VITT)

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Hi friends, This post is regarding one of the rarer side effects of COVID 19 vaccine. Last year, with the onset of COVID pandemic, we were all eagerly looking for a solution and it was vaccine. Now we have so many vaccines, available from different brands, and they have been proven to be highly safe and effective. In late February 2021, a prothrombotic syndrome was observed in a small number of individuals who received certain adenoviral vector-based vaccines to COVID 19 Implicated vaccines: Ø   ChAdOx1 CoV- 19 vaccine (AstraZeneca, University of Oxford and Serum Institute of India) Ø   Ad26.COV2.S vaccine (Janssen;Johnson & Johnson) This syndrome was named as vaccine –indced immune thrombotic thrombocytopenia(VITT). The other names are -       thrombosis with thrombocytopenia syndrome (TTS) and -       vaccine- indced prothrombotic   immune thrombocytopenia(VIPIT) We shall talk about the salient features of VITT in this post Pathophysiology :   VITT is caus
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