Pediatric reference intervals for hematology parameters in healthy infants and young children in Iran

Author:

Mohammadi Maliheh1,Ghazizadeh Hamideh23ORCID,Mohammadi‐Bajgiran Maryam3,Kathryn Bohn Mary24ORCID,Yaghooti‐Khorasani Mahdiyeh3,Kamel Khodabandeh Atieh3,Steele Shannon24,Torabzadeh Khorasani Niyusha1,Ferns Gordon A.5,Boskabadi Hassan6,Esmaily Habibollah7,Adeli Khosrow24ORCID,Assaran Darban Reza1,Ghayour‐Mobarhan Majid3ORCID

Affiliation:

1. Department of Biology, Mashhad Branch Islamic Azad University Mashhad Iran

2. CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine The Hospital for Sick Children Toronto Canada

3. International UNESCO Center for Health‐Related Basic Sciences and Human Nutrition Mashhad University of Medical Sciences Mashhad Iran

4. Department of Laboratory Medicine & Pathobiology University of Toronto Toronto Canada

5. Division of Medical Education, Falmer Brighton & Sussex Medical School Brighton UK

6. Department of Pediatrics, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran

7. Social Determinants of Health Research Center Mashhad University of Medical sciences Mashhad Iran

Abstract

AbstractIntroductionDefining accurate age‐ and sex‐specific reference intervals (RIs) for hematology parameters, especially for the pediatric population, is important for making an appropriate clinical diagnosis. To address gaps, we established age‐specific RIs for 11 hematologic parameters in Iranian children younger than 30 months for the first time.MethodsFresh whole blood samples collected from a total of 344 participants (males: 158 and females: 186) ages 3 days to 30 months, with a mean age of 12.91 ± 7.15 months, were recruited from healthcare centers in Mashhad, Iran. Hematologic parameters, including complete blood count (CBC), were analyzed on the Sysmex auto‐analyzer system (KX‐21 N). RIs were calculated with 90% confidence intervals using the direct method based on CLSI Ep28‐A3 and C28‐A3 guidelines.ResultsNone of the CBC parameters required sex partitioning. Of 11 CBC parameters, six required age partitions of 3 days–<4 months, 4–<10, 10–<15, and 4–<30 months. Five parameters (i.e., white blood cell count, mean corpuscular hemoglobin concentration, mean platelet volume, red cell distribution width, and platelet distribution width) did not demonstrate age‐specific changes. RIs of red blood cell count and hematocrit, as well as hemoglobin, increased with age, while mean corpuscular volume, mean corpuscular hemoglobin, and platelet count, decreased with age.ConclusionIn this study, we established RIs for 11 hematology parameters in young children. Age partitioning was required for six parameters demonstrating marked changes during the early period of growth and development and necessitating the use of pediatric‐specific reference standards.

Publisher

Wiley

Subject

Biochemistry (medical),Clinical Biochemistry,Hematology,General Medicine

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