2021 update of the 2012 ICSH Recommendations for identification, diagnostic value, and quantitation of schistocytes: Impact and revisions

International Council for Standardization in Hematology (ICSH), Gina Zini, Giuseppe d'Onofrio, Wendy N. Erber, Szu Hee Lee, Yutaka Nagai, Grzegorz W. Basak, Jean François Lesesve

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)

Abstract

In 2012, the International Council for Standardization in Hematology (ICSH) published recommendations for the identification, quantitation, and diagnostic value of schistocytes. In the present review, the impact of these recommendations is evaluated. This work is based on citations in peer-reviewed papers published since 2012. The first 2012 ICSH Recommendations have also been revised to incorporate newly published data in the literature and current best laboratory practice. Recommended reference ranges have been proposed for healthy adults and full-term neonates of 1% or less schistocytes. More than 1% of morphologically identified schistocytes on the blood film are considered suspicious for thrombotic microangiopathy. For preterm infants, a normal level of 5% or less is recommended. The fragment red cell count (FRC) generated by some automated hematological analyzers provides a valuable screening tool for the presence of schistocytes. Specifically, the absence of FRCs can be used as a valuable parameter to exclude the presence of schistocytes on the blood film. The validity and usefulness of microscope schistocytes and automated FRCs, respectively, are discussed in the context of the laboratory diagnostic tests used for thrombotic microangiopathies.

Original languageEnglish
Pages (from-to)1264-1271
Number of pages8
JournalInternational Journal of Laboratory Hematology
Volume43
Issue number6
DOIs
Publication statusPublished - Dec 2021

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