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Establishment of reference intervals for pediatric complete capillary blood counts: A multicenter study in Beijing
Qiujin Sun1, Yuhong Yue2, Yu Tian1
1Department of Clinical Laboratory, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing, China.
Insights
This study establishes crucial pediatric reference intervals for capillary blood cell counts in China. These findings provide essential diagnostic criteria for childhood diseases, improving healthcare for children.
Area of Science:
- Hematology
- Pediatric Medicine
- Clinical Chemistry
Background:
- Clinical reference intervals are vital for distinguishing healthy and sick individuals.
- Existing reference intervals often lack pediatric data, particularly in China.
- This study addresses the need for localized pediatric reference intervals for blood cell counts.
Purpose of the Study:
- To establish and validate pediatric reference intervals for capillary blood cell counts in China.
- To provide essential diagnostic criteria for childhood diseases in the region.
Main Methods:
- Utilized capillary complete blood count (CCBC) data from 9942 children aged 6 months to 7 years in Beijing, China.
- Followed the EP28-A3c guideline from the Clinical and Laboratory Standards Institute for data collection.
- Validated the established intervals with 508 healthy subjects.
Main Results:
- Established pediatric reference intervals for 17 CCBC parameters.
- Observed sex-based differences in red blood cell count, RDW, MCH, and MCV.
- Identified age-related trends in RBC, hemoglobin, hematocrit, neutrophils, and lymphocytes.
- Confirmed racial and geographical variations in reference interval limits.
- Validation showed proportions within 90.9%-100% of established intervals.
Conclusions:
- Provides localized reference intervals for capillary blood cell counts in the pediatric population of Beijing, China.
- Offers foundational criteria for diagnosing, treating, and assessing childhood diseases in China.
- Highlights the importance of region-specific reference intervals in pediatric healthcare.
Introduction:
Clinical reference intervals represent the normal range of clinical parameters for distinguishing healthy and sick individuals, and they show some variation among different populations. Many reference intervals are still lacking for the pediatric population in China. Thus, the aim of this study was to establish and validate pediatric reference intervals for capillary blood cell counts.
Methods:
A total of 9942 children were enrolled from 10 medical institutions in Beijing, China, for capillary complete blood count (CCBC) values according to the EP28-A3c guideline issued by the Clinical and Laboratory Standards Institute.
Results:
Pediatric reference intervals for 17 CCBC parameters were established for children aged 6 months to 7 years. The red blood cell count and red blood cell distribution width were generally higher in males than in females, and the mean corpuscular hemoglobin and mean corpuscular volume were higher in females than in males. The red blood cell, hemoglobin, hematocrit, and neutrophil percentages increased while the percentage of lymphocytes decreased with age. The overall trends for each reference interval were relatively similar in different ethnic groups and regions in the world, but with variation in the upper and lower limits, which confirms the existence of racial and geographical differences. Further validation with 508 healthy subjects showed that the verified proportions were within 90.9%-100% of the reference intervals.
Conclusions:
This study offers local reference intervals for CCBC values for the pediatric population in Beijing, China, and thus provides basic criteria for the diagnosis, treatment, and health assessment of childhood diseases in China.
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