Jump to ContentJump to Main Navigation
Show Summary Details

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

IMPACT FACTOR increased in 2015: 3.017
Rank 5 out of 30 in category Medical Laboratory Technology in the 2014 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2015: 0.873
Source Normalized Impact per Paper (SNIP) 2015: 0.982
Impact per Publication (IPP) 2015: 2.238

249,00 € / $374.00 / £187.00*

See all formats and pricing


Select Volume and Issue


30,00 € / $42.00 / £23.00

Get Access to Full Text

Granularity Index of the SYSMEX XE-5000 hematology analyzer as a replacement for manual microscopy of toxic granulation neutrophils in patients with inflammatory diseases

Mathias Zimmermann1, a / Malte Cremer2, a / Christina Hoffmann1 / Karin Weimann3 / 1

1Institute of Laboratory Medicine and Pathobiochemistry, Charité Universitätsmedizin Berlin, Berlin, Germany

2Department of Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany

3Department of Anesthesiology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany

aM. Zimmermann and M. Cremer contributed equally to this work.

Corresponding author: Dr. Andreas Weimann, Charité Universitätsmedizin Berlin, Institut für Laboratoriumsmedizin und Pathobiochemie, Augustenburger Platz 1, 13353 Berlin, Germany Phone: +49 30 450669032, Fax: +49 30 450569900

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 49, Issue 7, Pages 1193–1198, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2011.188, May 2011

Publication History

Published Online:


Background: When certain inflammatory processes occur, toxic granulation neutrophils (TGNs) appear in the blood showing prominent cytoplasmic granules. Currently, the granularity of TGNs is analyzed by manual microscopy of blood smears. The SYSMEX XE-5000 is an automated hematology analyzer, which can measure toxic granulation of TGNs by calculating the Granularity (GI) Index. In this study we investigated if the GI-Index is suitable as a parameter for the TGN granularity in inflammatory diseases.

Methods: An evaluation of the toxic granulation neutrophil (TGN) granularity by manual microscopy, the GI-Index and the C-reactive protein (CRP) concentrations of 158 patients were determined. Blood samples from 40 healthy individuals were incubated with lipopolysaccharide (LPS) for in vitro kinetic measurements of the GI-Index. Furthermore, time course measurements of the GI-Index and CRP concentrations of 100 intensive care unit patients were performed.

Results: The GI-Index correlated with the microscopic rating of TGNs (n=158; rs=0.839; p<0.0001). When incubating the blood samples with LPS, the neutrophils displayed hypogranulation 30 min after incubation and a hypergranulation after 90 min. In vivo, the GI-Index indicated changes of the bacterial infection status 1 day earlier than the CRP concentration. The correlation of CRP and GI-Index varied between the patient cohorts (n=158; rs=0.836) (n=100; r=0.177), depending on the cause and extent of inflammation.

Conclusions: The GI-Index is suited to quantify the granularity of TGNs. The GI-Index is an automated, standardized parameter available on a 24 h basis. We suggest that it replace the time-consuming, subjective and semiquantitative microscopic procedure.

Keywords: C-reactive protein; GI-Index; granularity; manual microscopy; toxic granulation neutrophils

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Devon S. Chabot-Richards and Tracy I. George
Clinics in Laboratory Medicine, 2015, Volume 35, Number 1, Page 11
M. Bhargava, S. Saluja, U. Sindhuri, A. Saraf, and P. Sharma
International Journal of Laboratory Hematology, 2014, Volume 36, Number 1, Page e11
Yaoling Luo, Jianhua Lin, Hao Chen, Jingping Zhang, Songguo Peng, and Miaohuan Kuang
Clinica Chimica Acta, 2013, Volume 422, Page 5
M. Zimmermann, C. Otto, J.-B. Gonzalez, S. Prokop, and K. Ruprecht
International Journal of Laboratory Hematology, 2013, Volume 35, Number 6, Page 580
Borae G. Park, Chan-Jeoung Park, Sue Kim, Chan-Hee Yoon, Duck-Hee Kim, Seongsoo Jang, and Hyun-Sook Chi
International Journal of Laboratory Hematology, 2012, Volume 34, Number 6, Page 584

Comments (0)

Please log in or register to comment.