A Comparative Analysis of Peripheral Blood Smear, RBC Indices, and RBC Histograms for Diagnosing Anemia in Adults

Abstract

Background: Anemia, a condition characterized by a reduction in the number of RBCs or the hemoglobin concentration, affects millions of adults globally and can arise from a variety of underlying causes. A correct and prompt diagnosis is essential for effective treatment and management. This study seeks to compare and evaluate the diagnostic efficacy of peripheral blood smear (PBS), RBC indices, and RBC histograms in diagnosing anemia among adults.

Methods: The study included 150 adult patients diagnosed with anemia, categorized into three groups: microcytic, macrocytic, and normocytic anemia. Each patient underwent PBS analysis, RBC indices measurements (mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH], and mean corpuscular hemoglobin concentration [MCHC]), and RBC histogram analysis via an automated hematology analyzer. A control group of 30 healthy individuals was also included for comparison.

Results: PBS analysis showed distinct morphological features for each anemia type. Microcytic anemia was characterized by small, pale RBCs, while macrocytic anemia displayed large, oval-shaped RBCs, and normocytic anemia exhibited normal RBC morphology. The RBC indices reflected these findings, with significant deviations in MCV and MCH. RBC histograms further supported these results by illustrating shifts in peak distribution and variations in width, with microcytic anemia showing a leftward shift and macrocytic anemia showing a rightward shift.

Conclusion: This study emphasizes the complementary roles of PBS, RBC indices, and RBC histograms in diagnosing anemia. PBS provides valuable qualitative morphological details, RBC indices offer quantitative data on RBC size and hemoglobin content, and RBC histograms provide insights into RBC size distribution, all of which together enhance the accuracy of anemia diagnosis.

Keywords: Anemia, Peripheral Blood Smear, RBC Indices, RBC Histogram, Diagnostic Tools