Clinical and Applied Thrombosis/Hemostasis

 

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First published on July 3, 2008
Clinical and Applied Thrombosis/Hemostasis 2008, doi:10.1177/1076029608319879

Article

The Effectiveness of Measuring for Fragmented Red Cells Using an Automated Hematology Analyzer in Patients With Thrombotic Microangiopathy

Yasunori Abe, Hideo Wada*, Eri Yamada, Maki Noda, Makoto Ikejiri, Junji Nishioka, Toshihiko Kobayashi, Takeshi Matsumoto, Masahiro Masuya, Syuji Isaji, Masanobu Usui, Sinji Uemoto, MD,Ph.D, Naoyuki Katayama, and Tsutomu Nobori

* To whom correspondence should be addressed. E-mail: wadahide{at}clin.medic.mie-u.ac.jp.


  Abstract
Thrombotic microangiopathy (TMA) or thrombotic thrombocytopenic purpura (TTP) is a life-threatening syndrome characterized by increased number of fragmented red cells (FRCs) and thrombocytopenia. FRCs can be measured using the recently developed automated hematology analyzer XE-2100. The normal range for FRCs is 0% to 0.205%, as determined by the automated hematology analyzer XE-2100. The FRC count is significantly elevated in patients with TMA associated with liver transplantation, bone marrow transplantation, or TTP. In patients with TMA after liver transplantation, the FRC count is significantly higher than in those without TMA. In receiver operating characteristic analysis for the diagnosis of TMA, the area under the curve is 0.986, suggesting that FRC is a useful marker for the diagnosis of TMA. When the cutoff value of FRC for TMA is 1.2%, the sensitivity is 90% and the specificity is 96%, indicating that FRC is the most useful screening test for the diagnosis of TMA.


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