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- Title
High diagnostic accuracy of the Sysmex XT-2000iV delta total nucleated cells on effusions for feline infectious peritonitis.
- Authors
Giordano, Alessia; Stranieri, Angelica; Rossi, Gabriele; Paltrinieri, Saverio
- Abstract
Background The Δ WBC (the ratio between DIFF and BASO counts of the Sysmex XT-2000iV), hereafter defined as Δ TNC (total nucleated cells), is high in effusions due to feline infectious peritonitis ( FIP), as cells are entrapped in fibrin clots formed in the BASO reagent. Similar clots form in the Rivalta's test, a method with high diagnostic accuracy for FIP. Objectives The objective of this study was to determine the diagnostic accuracy for FIP and the optimal cutoff of Δ TNC. Methods After a retrospective search of our database, DIFF and BASO counts, and the Δ TNC from cats with and without FIP were compared to each other. Sensitivity, specificity, and positive and negative likelihood ratios ( LR+, LR−) were calculated. A ROC curve was designed to determine the cutoff for best sensitivity and specificity. Results Effusions from 20 FIP and 31 non- FIP cats were analyzed. The Δ TNC was higher ( P < .001), and BASO and DIFF counts were lower ( P < .001 and P < .05) in FIP than in non- FIP cats. Only 2 FIP cats with atypical effusions had a Δ TNC < 3.0. The cutoff identified by the ROC curve (area under curve: 0.94; P < .001) was 1.7 (Sensitivity = 90.0%; Specificity = 93.53%; LR+ = 13.9; LR− = 0.1). A Δ TNC > 2.5 had 100% specificity. Conclusions The Δ TNC has a high diagnostic accuracy for FIP-related effusions by providing an estimate of precipitable proteins, as the Rivalta's test, in addition to the cell count. As fibrin clots result in false lower BASO counts, the Δ TNC is preferable to the WBC count generated by the BASO channel alone in suspected FIP effusions.
- Subjects
PERITONITIS; INTRA-abdominal infections; DIFFUSE peritonitis; CYTOLOGY; FIBRINOGEN
- Publication
Veterinary Clinical Pathology, 2015, Vol 44, Issue 2, p295
- ISSN
0275-6382
- Publication type
Article
- DOI
10.1111/vcp.12241