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. 2024 Dec 11:12:1510733.
doi: 10.3389/fped.2024.1510733. eCollection 2024.

Reference ranges for complete blood count in children and adolescents with Down syndrome

Martina Lattuada #  1 , Giulia Capitoli #  2   3 , Marco Casati  4 , Alessandra Lazzerotti  5 , Oscar Maglia  6 , Giulia Maria Ferrari  5 , Chiara Fossati  5 , Andrea Biondi  1   5 , Alessandro Cattoni  1   5 , Paola Corti  5
Affiliations

Reference ranges for complete blood count in children and adolescents with Down syndrome

Martina Lattuada et al. Front Pediatr. .

Abstract

Introduction: Down syndrome (DS) is linked to unique hematopoietic characteristics that affect complete blood count (CBC) parameters. Accurate reference ranges are essential for proper CBC interpretation in this population.

Methods: This retrospective study analyzed 2,627 CBCs from 481 DS patients, aged 31 days to 18 years, at a tertiary care center in Italy. Patients with significant comorbidities were excluded to ensure a homogeneous group.

Results: CBC parameters were assessed to establish age- and sex-specific reference ranges. Centile charts were developed for each parameter, and an online tool was created to allow clinicians to compare individual CBC results with the new ranges. Comparisons with the general pediatric population revealed significant differences, particularly in hemoglobin, hematocrit, and mean corpuscular volume, which were higher in DS (p < 0.001). In contrast, a significant percentage of CBCs showed white blood cell counts below the 2.5th centile of healthy controls (p < 0.001), except for the 31 days-1 year age group. A similar trend was observed for lymphocytes (p < 0.001) in the 1-18 years group.

Discussion: These newly established DS-specific reference ranges provide clinicians with a crucial tool for evaluating CBC results, potentially reducing unnecessary tests and emphasizing the need for tailored clinical assessment in managing this unique population.

Keywords: Down syndrome; complete blood count; hematopoiesis; pediatric; reference ranges.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Graphical representation of centiles of CBC parameters in the study cohort of children and adolescents with DS. The figure shows the centile distribution for hemoglobin (HB, panel A), hematocrit (HTC, panel B), mean corpuscular volume (MCV, panel C), red blood cells (RBC, panel D), platelets (PLT, panel E), white blood cells (WBC, panel F), neutrophils (NEU, panel G) and lymphocyte (LYM, panel H).
Figure 2
Figure 2
Comparison of the centile distribution of CBC parameters vs. healthy controls from the literature, declined by age groups and sexes.
Figure 3
Figure 3
Graphical representation of the mean (95% CI) of CBC DS parameters of our study vs. Garcia's DS population, Harvey's DS population and Harvey's healthy controls, declined by age groups and sexes.
See this image and copyright information in PMC

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