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All Journal Medical Journal of Indonesia Mutiara Medika: Jurnal Kedokteran dan Kesehatan Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Usi Sukorini
Dep. Patologi klinik, FK UGM/RS. Sardjito Jl. Kesehatan, Sekip Utara Yogyakarta 55281
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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The effects of excessive disodium ethylene diamine tetraacetic acid (Na2EDTA) anticoagulant concentration toward hematology profile and morphology of erythrocytes in peripheral blood examination Ratnaningsih, Tri; Sukorini, Usi; Gumilang, Rizki A.
Medical Journal of Indonesia Vol 15, No 3 (2006): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (374.098 KB) | DOI: 10.13181/mji.v15i3.233

Abstract

The purpose of this study is to know whether there are differences between hematology profile and morphology of erythrocytes of blood specimens which are prepared with excessive Na2EDTA anticoagulant in different concentration. This study was conducted in Faculty of Medicine Gadjah Mada University. The criteria of subject were male, age from 18 until 22 years old and healthy, ascertained from history taking and vital sign examination. Blood samples from 33 subjects were taken using vein puncture. Two millimeters blood was divided into 4 Na2EDTA-containing tubes. Before that, one drop of blood without Na2EDTA anticoagulant was used for making control blood film right after vein puncture. Each tubes contained different concentration of anticoagulant. The first tube contained Na2EDTA in standard concentration 2 mg/dl; the remaining tubes contained consecutively, 4 mg/dl, 6 mg/dl, and 8 mg/dl. Those samples were immediately examined using SYSMEX SE-9500 automatic analyzer for measuring erythrocytes hematological profile and were stained with Wright staining for morphological examination. These procedures were done before 20 minutes of vein puncture. There were significant decrease of RBC count, HGB, HCT, and MCHC and also significant increase of MCV and RDW between different concentrations of excessive Na2EDTA anticoagulant. MCH did not have significant result. Morphological examination showed significant morphological changes in the form of echinocytes and appearance of ghost cells in the sample treated with excessive Na2EDTA anticoagulant concentration. In conclusion, there are differences in hematological profile and morphology of erythrocytes among blood specimen which are prepared with excessive Na2EDTA anticoagulant in different concentration, except for MCH. Excessive Na2EDTA anticoagulant concentration will affect the blood specimen for peripheral blood examination of erythrocytes by interfering morphology and some of hematological parameters. (Med J Indones 2006; 15:157-64) Keywords: Na2EDTA, erythrocytes, hematology parameters, echinocytes, ghost cells
The effect of excessive disodium ethylene diamine tetraacetic acid (Na2EDTA) anticoagulant concentration on leukocytes profile in peripheral blood examination Sukorini, Usi; Ratnaningsih, Tri; Ikarumi, Diannisa
Medical Journal of Indonesia Vol 16, No 3 (2007): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (274.473 KB) | DOI: 10.13181/mji.v16i3.271

Abstract

Accuracy of leukocytes profile assessment is influenced by several pre analytical factors, among others, the anticoagulant concentration. EDTA is one of the most frequently used anticoagulant in peripheral blood examination. Several references stated that inappropriate concentration of EDTA anticoagulant in blood sample may affect the result of leukocytes profile in peripheral blood examination. The aim of this study was to evaluate whether there are differences among leukocytes profile in peripheral blood examination specimens, which were prepared with excessive Na2EDTA anticoagulant in different concentration. This study was conducted in Faculty of Medicine, Gadjah Mada University. Blood samples from 30 subjects were taken using vein puncture. Two millimeters blood was divided into 4 Na2EDTA-containing tubes. Before that, one drop of blood without Na2EDTA anticoagulant was used to make blood film right after vein puncture, as control. Each tubes contained different concentration of anticoagulant. The first tube contained Na2EDTA in standard concentration 2 mg/ml; the remaining tubes contained 4 mg/ml, 6 mg/ml, and 8 mg/ml respectively. These samples were immediately examined using SYSMEX SE-9500 automatic cell counter to measure the total and differential leukocytes count; and were stained with Wright staining for morphological examination under the microscope. These procedures were done before 20 minutes of vein puncture. There were significant decrement of total leukocytes count, absolute differential leukocytes count and monocyte percentage following excessive Na2EDTA administration. Neutrophil percentage was found to be relatively increased and the difference was significant. Lymphocyte, eosinophil and basophil percentages were not significantly different. Morphological examination showed significant increment in irregular cytoplasm margin, vacoulation and irregular nuclei lobes following excessive Na2EDTA administration. It is concluded that excessive concentration of Na2EDTA used in blood specimen preparation, will lead to changes in leukocytes profile as the concentration increased. Standard Na2EDTA anticoagulant concentration did not alter any leukocytes count and morphology, except for irregular cytoplasm margin and irregular nuclei lobes. (Med J Indones 2007; 16:168-75)Keywords: Na2EDTA, anticoagulant, leukocytes profile, leukocytes count, leukocytes morphology
THE RISK FACTOR OF ALLOANTIBODY FORMATION IN THALASSEMIA PATIENTS RECEIVING MULTIPLE TRANSFUSION (Faktor Kebahayaan Terbentuknya Aloantibodi pada Pasien Talasemia yang Menerima Transfusi Darah Berulang) Fridawati, Veronica; Triyono, Teguh; Sukorini, Usi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 3 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i3.1239

Abstract

Untuk kelangsungan hidup pasien talasemia intermediet dan mayor, memerlukan transfusi darah secara teratur. Transfusi berulangini berpeluang membentuk aloantibodi yang dapat menyebabkan kebahayaan hemolitik. Maka transfusi berulang akan memperberathemolitik karena pada pasien talasemia sudah ada proses tersebut. Tujuan penelitian ini adalah untuk mengetahui berbagai faktorkebahayaan untuk terbentuknya aloantibodi pada pasien talasemia yang mendapat transfusi darah berulang khusus di RSUP Fatmawati,Jakarta. Cara meneliti ini menggunakan rancangan potong lintang. Subjek penelitian adalah semua pasien talasemia yang mendapattransfusi darah berulang di RSUP Fatmawati Jakarta yang memenuhi patokan kesertaan. Sebanyak 81 subjek diikutkan dalam penelitianini. Data pada penelitian ini di analisis secara statistik dengan uji Chi Kuadrat. Hasil menguji secara Chi Kuadrat menunjukkan: kelamin,suku, diagnosis, selang transfusi darah, jenis darah, reaksi yang terkait, riwayat keluarga, kadar Hb. Kadar feritin dan golongan darahbukan merupakan faktor kebahayaan untuk terbentuknya aloantibodi, sedang faktor usia, jumlah kantong darah yang ditransfusikan,keberadaan komplikasi akibat transfusi darah dan lama masa waktu menerima darah transfusi, merupakan faktor kebahayaan untukterbentuknya aloantibodi pada pasien talasemia yang mendapat transfusi berulang di RSUP Fatmawati.
Profil Pemeriksaan Fragilitas Osmotik Eritrosit di RS. Dr. Sardjito Gugun, Adang Muhammad; Sukorini, Usi
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 4, No 2 (2004)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v4i2.1745

Abstract

Osmotic fragility test (OFT) is performed to differentiate anemia diagnose with erythrocyte physical changing. In thalassemia and hemolytic anemia, OFT probably gave variation results that can cause erroneous anemia etiology trac¬ing. Aims of this research are to describe the OFT profile and its comparison with peripheral blood morphology in thalassemia and hemolytic anemia.The method, this retrospective study was conducted in Dr. Sardjito hospital at January 2002 to June 2004. Chi-Square test was used to compare thalassemia and hemolytic anemia proportion in the OFT groups. OFT results from 61 sub¬jects were : increasing 17 (27,8%), increasing-decreasing 17 (27,8%), de¬creasing 15 (24,4%), and normal 12 (20%). There were significantly differ-ence proportions in thalassemia group between decreasing OFT to increasing and normal OFT (p-0,005 ; p=0,002), but no difference to increasing-de¬creasing group. In hemolytic anemia group, the difference proportion found significantly between increasing OFT to normal, increasing-decreasing and decreasing OFT (p=0,03; p-0,005; p=0,000, respectively). In increasing-de¬creasing OFT group, there was no difference in type anemia (p=0,32). Mor¬phologically, target cell was found in 81 % of thalassemia, and spherocyte in 70% of hemolytic anemia. In Dr. Sardjito Hospital, OFT gave variation profile and in Thalassemia and hemolytic anemia groups, morphology evaluation are needed to confirm OFT results.Latar Belakang: Pemeriksaan fragilitas osmotik eritrosit (FOE) ini dilaksanakan untuk membantu diagnosis banding beberapa jenis anemia dengan sifat fisik eritrosit berubah. Aplikasi klinis, Talasemia dan anemia hemolitik memberikan hasil bervariasi sehingga dapat menimbulkan kesalahan interpretasi dalam melacak jenis maupun etiologi anemia.Tujuan penelitian ini adalah mengetahui variasi hasil FOE dan kesesuaian gambaran morfologi darah tepi pada talasemia dan anemia hemolitik. Penelitian retrospektif ini dilakukan menggunakan data rekam medik. Subyek adalah pasien yang diperiksa fragilitas osmotik eritrositnya di laboratorium Patologi Klinik RS. Dr. Sardjito antara Januari tahun 2002 sampai dengan Juni 2004. Uji Chi- square terhadap proporsi talasemia dan anemia hemolitik pada kelompok hasil FOE. Dari 61 subyek, variasi hasil FOE meliputi : peningkatan fragilitas 17 (27,8%), penurunan fragilitas 17 (24,4%), campuran peningkatan dan penurunan 15 (27,8%) dan normal 12 (20%). Terdapat perbedaan bermakna proporsi talasemia kelompok penurunun FOE terhadap kelompok peningkatan FOE (p=0,005) dan FOE normal (p= 0,002), namun tidak berbeda bermakna dengan hasil campuran penurunan dan peningkatan fragilitas (p= 0,26). Terdapat perbedaan bermakna proporsi ane¬mia hemolitik pada kelompok dengan peningkatan FOE terhadap kelompok normal FOE, campuran penurunan dan peningkatan FOE dan penurunan FOE (p =0,03; p= 0,005; p= 0,000). Tidak terdapat perbedaan bermakna proporsi jenis anemia pada hasil campuran penurunan dan peningkatan FOE (p= 0,32). Gambaran morfologi darah tepi pada kelompok talasemia, 81% memiliki sel target dan pada kelompok anemia hemolitik, 70% memiliki sel spherosit.Hasil FOE di RS Dr. Sardjito menunjukkan gambaran variasi, talasemia maupun anemia hemolitik membutuhkan konfirmasi morfologi darah tepi untuk meninjau kesesuaiannya.
Multiple Myeloma with Suspected Non-Secretory Type Indrarsi, Annisa Ginar; Sukorini, Usi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1575

Abstract

Multiple Myeloma (MM) is a hematological malignancy characterized by clonal plasma cell in bone marrow that produceabnormal globulin, which resulted in monoclonal gammopathy. Multiple Myeloma Non-Secretory (MMNS) is a very rareform of multiple myeloma with monoclonal plasmocytic proliferation in bone marrow supported by clinical manifestationand radiological findings. However, plasma cells fail to secrete immunoglobulin. A 44-year-old female came to SardjitoGeneral Hospital with main complaints of weakness and back pain. General weakness and pale palpebral conjunctiva were6 observed (+/+), liver and spleen were not palpable. Blood test results were as follows: Hb 3.0 g/dL, RBC 1.07 x 10 / μL, WBC3 3 562 x 10 /μL, PLT 114 x 10 /μL, A/G ratio 1.07, BUN 51.5 mg/dL, creatinine 4.62 mg/dL, and calcium 3.1 mmol/L. Skeletalsurvey suggested a multiple osteolytic. Protein electrophoresis revealed hypogammaglobulinemia with no M-spike. Therewere 66% of plasma cells in bone marrow. Patient was diagnosed by MMNS. Diagnosis MMNS can be established if clonalplasmacytes is accompanied with renal insufficiency and hypercalcemia. However, monoclonal gammopathy was not foundin serum protein electrophoresis. A case reported of 44-year-old female diagnosed as MMNS with 'punched out' multipleosteolytic, increased plasma cells in bone marrow without evidence of paraprotein in circulation proved by low A/G ratio andnegative M-spike.
Co-Authors Adang Muhammad Gugun, Adang Muhammad Diannisa Ikarumi Fridawati, Veronica Indrarsi, Annisa Ginar Rizki A. Gumilang teguh triyono Tri Ratnaningsih