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Spurious Leukocyte Counts and an Abnormal Histogram Pattern Due to Fibrin Clumps

  • Ashish Kumar
  • Ritesh Goswami
  • Markas Masih
  • Naveen Kakkar
Correspondence
  • 13 Downloads

Dear Editor

Spuriously low or high automated WBC counts seen in laboratory practice can cause diagnostic and therapeutic dilemma. WBC histograms and scatterplots may have clues to the presence of an abnormal WBC population or interfering substances [1, 2]. We present a series of 14 patients in whom the automated WBC count was spuriously elevated due to interference by fibrin clumps. These patients were undergoing treatment for various hematological disorders (9 patients were chemotherapy and 5 patients were post bone marrow transplant).

Complete blood count (CBC) was done on BC 3000 plus (Mindray) three-part automated hematology analyzer. In 12 of the 14 patients, daily or alternate day counts were being monitored due to low WBC count. In 10 of the 14 patients, the WBC count reported initially was much higher than the expected rise over 24 h. In four patients, presence of fibrin clumps was suspected on viewing the abnormal WBC histogram pattern. Repeat samples were requested in all 14...

Notes

Compliance with Ethical Standards

Conflict of interest

The author declares that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No patient/subject identifying information has been disclosed in the manuscript. No patient/subject intervention was done and the subjects were not exposed to any risks during the study.

Informed Consent

Since the study involved a retrospective review of data only from routine testing offered by the laboratory, separate informed consent was not taken for the study. Repeat sampling was done as part of routine protocol in case of suspected pre- analytic problem. “For this type of study formal consent is not required.”

References

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    Bain BJ (ed) (2002) Detecting erroneous blood counts. In: Blood cells: a practical guide, 3rd edn. Blackwell Science, London, pp 155–74Google Scholar
  2. 2.
    Zandecki M, Genevieve F, Gerard J, Godon A (2007) Spurious counts and spurious results on haematology analysers: a review. Part II: white blood cells, red blood cells, haemoglobin, red cell indices and reticulocytes. Int J Lab Hematol 29:21–41PubMedGoogle Scholar
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    Geneviève F, Godon A, Marteau-Tessier A, Zandecki M (2012) Automated hematology analysers and spurious counts part 2. Leukocyte count and differential. Ann Biol Clin (Paris) 70:141–154Google Scholar
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    Maeda K, Pohlad R (1980) Pseudoleukocytosis due to fibrin strands. Am J Clin Pathol 74:497Google Scholar
  5. 5.
    Gulliani GL, Hyun BH, Gabaldon H (1977) Falsely elevated automated leukocyte counts on cryoglobulinemic and/or cryofibrinogenemic blood samples. Lab Med 8:14–16CrossRefGoogle Scholar

Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  • Ashish Kumar
    • 1
  • Ritesh Goswami
    • 1
  • Markas Masih
    • 1
  • Naveen Kakkar
    • 2
  1. 1.Departments of Clinical Haematology, Hemato-oncology and Bone Marrow (Stem Cell) TransplantationChristian Medical College and HospitalLudhianaIndia
  2. 2.Departments of PathologyChristian Medical College and HospitalLudhianaIndia

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