Manual examination of the peripheral blood smear (PBS) is currently performed on a fraction of samples sent for automated complete cell count. 39 children (age range 0-16.2 years) referred to a private paediatric practice during a 16-month period were retrospectively reviewed. Clinical scenarios, haematological features, laboratory-initiated PBS review, haematologist's PBS review and final diagnosis were described. Clinical indications included isolated thrombocytopenia (n = 10), unexplained bruises (n = 5), acute febrile illnesses (n = 11), anaemia (n = 8) and others (n = 5). The laboratory reviewed the PBS in 30 cases according to preset criteria and made no conclusive remarks. All slides were reviewed by a haematologist and a diagnosis was made in 27 (69%) cases, including 7 (78%) of the nine slides the laboratory did not review. The practice of laboratory-initiated PBS review requires re-evaluation. Haematologist-reviewed PBS is an important diagnostic tool for children with anaemia, bleeding disorders and acute febrile illnesses.
Keywords: blood cell count; child; diagnostic techniques and procedures; paediatric haematology; peripheral blood smear.
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