Segmented Neutrophil Size and Platelet Morphology in HIV/AIDS Patients

Richard Bamberg; Jennifer Johnson

doi:10.29074/ascls.15.1.18

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Richard Bamberg, PhD CLDir(NCA), CHES⇑
1. is Professor and Chairman, Department of Clinical Laboratory Science at East Carolina University, Greenville NC
Jennifer Johnson
1. is a Technologist at Carl Clinical Laboratory, Duke University Medical Center, Durham NC

Address for correspondence: Richard Bamberg PhD, CLDir(NCA), CHES, Department of Clinical Laboratory Science, School of Allied Health Sciences, East Carolina University, Greenville, North Carolina 27858-4353. (252) 328-4417, (252) 328-4470 (fax). bambergw{at}mail.ecu.edu

Abstract

OBJECTIVE: A study was conducted to determine if HIV/AIDS patients have smaller than normal size neutrophils and increased prevalence of abnormal platelet morphology.

DESIGN: Wright's-stained peripheral blood smears from 100 HIV/AIDS patients were evaluated for size of segmented neutrophils and degree of abnormal platelet morphology.

SETTING: East Carolina University, Greenville, North Carolina.

PARTICIPANTS: The study subjects consisted of 100 HIV/AIDS patients seen in an outpatient clinic in a teaching hospital in an academic health center. Peripheral blood smears were made from EDTA tubes drawn as a part of a routine immunology panel.

MAIN OUTCOME MEASURES: Segmented neutrophils from each of ten oil immersion fields were measured for diameter with a micrometer and the average diameter calculated. In addition, any platelet morphology abnormality, which was noted in at least five oil immersion fields, was recorded. One researcher evaluated one slide on each patient, and the second researcher randomly selected 20% of the subjects and performed the same procedure on a second slide for quality assurance of results.

RESULTS: A segmented neutrophil mean diameter of 15.1 microns was found. Though this mean is a mere 0.1 microns above the upper limit of the normal range of 10 to 15 microns, 53% of the patients had an observed average diameter above 15 microns. The HIV/AIDS patients' mean diameter was statistically different when compared to a normal population mean of 12.0 microns (T-test = 16.15, p <.0001), thus, showing a tendency for HIV/AIDS patients' segmented neutrophils to be large. Over half of the study subjects demonstrated abnormal platelet morphology including agranularity, small size, and giant size.

CONCLUSION: Neutrophil size as based on cell diameter, was found to be significantly larger for a sample of HIV/AIDS patients than the normal mean size. There was also a tendency for platelet morphology to be abnormal.

ABBREVIATIONS: AIDS = acquired immunodeficiency syndrome; AO = American Optical Corporation; ARC = AIDS related complex; CD = cluster of differentiation; HIV = human immunodeficiency virus.