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I concur with your proposed terms, far more accurate than my previous sketch.
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.
Having checked the Specimen CMT of APHL, there is a specimen type for a cyst fluid sample, in both HL7 and SNOMED:
Fluid, Cyst – CST – HL70487 equivalent to 258453008 |Cyst fluid sample (specimen)| SNOMED CT.
This concept can feed SPM-4, however it would make sense to me to have this specimen type also coded in the SYSTEM axis of LOINC, so as to be able to create LOINC terms for tests performed on this kind of specimen, more precise than Body fluid.
Does it make sense?
Tank you so much, Pam!
Thank you Pam, my best wishes to you for this new year.
I’m fully aware of the articulation of LOINC with HL7 standards V2, CDA and FHIR, and have a precise view of the SPM segment, of the former specimen CMET in V3, and of the Specimen resource in FHIR, being the initiator of the SpecimenDefinition resource. I’ve set in place the ongoing French translation of LOINC 10 years ago, and collaborated on several occasions with Daniel Vreeman in the past.
In my example of a European lab performing CEA on various body fluids, the ultimate goal is to have unambiguous order messages as well as CDA lab reports. The lab would like to have, beside the ‘CEA on Body fluid’ LOINC code (12515-3), another code with a meaning ‘CEA on a body fluid obtained by puncture from a cyst or an organ’. That would require the presence of such a SYSTEM, somewhat less generic than Body fluid.
Hence my question: Is there, among the more than 2,800 existing SYSTEM parts, a value approaching what I’m looking for.
In any case, I’m very much interested in the latest release of the CMT. Could you please point me to it?
Question related to this topic: Some labs have tests dedicated to fluid coming from cysts: pancreatic cyst, ovarian cyst, or unspecified cyst. For instance carcinoembryonic antigen on fluid from ovarian kyst.
Is there any value more specific than “Body fluid” for representing this kind of specimen?