Sideroblasts missing?

Legacy laboratory-loinc hematologycoagulation
1

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

2

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

3

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.

 

4

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.

5

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

6

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

7

Will do!

8