Haematologist-reviewed peripheral blood smear in paediatric practice

Area of Science:

• Pediatric Hematology
• Diagnostic Pathology

Background:

• Manual peripheral blood smear (PBS) examination is underutilized despite its diagnostic value.
• Automated complete cell counts lack the detail provided by manual smear reviews.

Purpose of the Study:

• To evaluate the diagnostic utility of laboratory-initiated versus hematologist-reviewed peripheral blood smears in children.
• To assess the effectiveness of PBS review in various pediatric clinical scenarios.

Main Methods:

• Retrospective review of 39 pediatric patients (0-16.2 years) referred to a private practice.
• Analysis of clinical indications, laboratory PBS review, hematologist PBS review, and final diagnoses.
• Comparison of diagnostic yield between laboratory and hematologist PBS reviews.

Main Results:

• The laboratory reviewed PBS in 30 cases with inconclusive remarks.
• A hematologist diagnosed 27 out of 39 cases (69%), including 78% of cases the lab did not review.
• Hematologist review proved vital for diagnosing anemia, bleeding disorders, and febrile illnesses.

Conclusions:

• Laboratory-initiated peripheral blood smear review practices require re-evaluation.
• Hematologist-reviewed peripheral blood smears are an essential diagnostic tool in pediatric hematology.
• Expert PBS review significantly improves diagnostic accuracy in children with hematological concerns.