The critical gap for pediatric reference intervals of complete blood count in China

Background: We examined the critical gap for pediatric reference intervals in China byvalidating 3 existing pediatric reference intervals (RIs) of complete blood count(CBC) respectively.

Methods: A total of 2255 healthy children attended physical examination in Beijing Children's Hospital. Fasted blood was sampled and CBC, including red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), platelet count (PLT) and white blood cell (WBC) count were measured by automated hematological analyzer Sysmex Xs-800i. The observed proportions of out-of-range (OOR) values were calculated by three RIs in order to examine its applicability.

Results: Compared with RIs of CBC recommended by Zhu Futang Practice of Pediatrics, the upper side OORs of RBC count, HGB, WBC count, and PLT deviated from upper reference limit, which ranged from 10% to 91.9%. On the contrary, the lower side OOR of WBC count was 64%. Compared with Chinese adult RIs, the upper side OORs of WBC count and PLT were >10%. While the lower sides OORs of RBC count, HGB and HCT were >10% among boys <14y. It appears that the RIs validated by Beijing Children's Hospital were relatively accurate RIs for children.

Conclusions: There is a gap for pediatric RIs in China. It is imperative to initiate research on establishing and validating pediatric RIs in China.