Sideroblasts missing?

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  • #455725
    François Macary
    Participant

    Hello,

    I can’t find any LOINC term for observations of sideroblasts (part of erythroblasts) . There is a need for 3 terms:

    sideroblasts type I ; sideroblasts type II ; sideroblasts type III (ring sideroblasts)

    See for instance: https://www.haematologica.org/article/view/5981

    Do they exist in LOINC under a different component name? Or should I request their creation?

    Thanks for your help

    François Macary

    #455728
    Pam Banning
    Moderator

    Hello Francois,

    I only located siderocytes and various normoblasts (basophilic, orthochromic or polychromatophilic)  in LOINC 2.69. The Haematologica article is a great reference; I wonder if you have another one that describes the type I, II and III when you request their creation.

    All the best,

    Pam Banning

    #455729
    François Macary
    Participant

    The article is indeed a rich source of information. Sideroblasts are <span style=”color: #000000; font-family: ‘Work Sans’, sans-serif; letter-spacing: 0.192px;”>erythroblasts with iron-loaded mitochondria visualized by Prussian blue staining (Perls’ reaction). As I understand it those </span><span style=”color: #000000; font-family: ‘Work Sans’, sans-serif; letter-spacing: 0.192px;”>iron-loaded mitochondria appear as “blue granules” on the microscopic image, aka “siderotic granules”.</span>

    A laboratory performing this test reports 4 quantitative observations expressed in percentage of the population of erythroblasts:

    – erythroblasts without granules                                                       ———- normal range: 50% – 90%

    – erythroblasts with 1 to 4 granules —> Type I                             ———- normal range: 10% – 50%

    – erythroblasts with 5 to 15 granules —> Type II               ———- normal range: 0%

    – erythroblasts with a ring of granules —> Type III                    ———- normal range: 0%

    Taken from University hospital of Rennes: https://facmed.univ-rennes1.fr/resped/hemato/cc/CD/cd/fr/dossiers/perlsf/perlsf.htm

    It looks like https://loinc.org/75376-4/ is tracking sideroblasts presence by <span style=”font-family: Lato, Helvetica, Arial, Lucida, sans-serif; font-size: 15.2px;”>Prussian-blue reaction</span>, which is a good start. Thus, I guess the compenent name I was looking for would be something like <span style=”font-family: Lato, Helvetica, Arial, Lucida, sans-serif;”>Siderocytes.HPF/100 Erythroblasts</span>

    So, what we are looking for is 4 quantitative terms using such a component expressed in count per 100 erythroblasts.

     

    #455730
    Pam Banning
    Moderator

    Hello again Francois,

    A few other thoughts on this:

    1. The method of microscopy.light.hpf could account for the .HPF instead of in the component, but I think using a method of Prussion Blue stain is more descript. It may be considered a given that in studying erythroblasts we are on the higher objective lens.

    2. In order to get the # granules (Type) into the component, you may want to consider Siderocytes.Type I/100 Erythroblasts as the component. The four qn terms might look like this:

    Siderocytes/100 Erythroblasts:NFr:Pt:Bld:Qn:Prussian Blue stain

    Siderocytes.Type I/100 Erythroblasts:NFr:Pt:Bld:Qn:Prussian Blue stain

    Siderocytes.Type II/100 Erythroblasts:NFr:Pt:Bld:Qn:Prussian Blue stain

    Siderocytes.Type III/100 Erythroblasts:NFr:Pt:Bld:Qn:Prussian Blue stain

    Thank you for the stimulating conversation; I never had the opportunity to run this assay in my past experiences.

    #455731
    François Macary
    Participant

    I concur with your proposed terms, far more accurate than my previous sketch.

    #455732
    Pam Banning
    Moderator

    Very glad to help. Just volunteering to help shape the attributes. We still rely on you, Francois, to make the submission with the denoted publications.

    All the best,

    Pam

    #455733
    François Macary
    Participant

    Will do!

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