Falsely Elevated Automated Leukocyte Counts on Cryoglobulinemia and/or Cryofibrinogenemic Blood Samples

Gulliani, G. L.; Hyun, Bong Hak; Gabaldon, Herminia

doi:10.1093/labmed/8.12.14

Cited by 8 publications

(7 citation statements)

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“…Particles related to cryofibrinogen or to fibrin have been reported to elevate WBC counts and at times PLT counts and, according to the reports, PLT and WBC counts may be found up to twice and up to 16 times the accurate value, respectively (Gulliani, Hyun & Gabaldon, 1977;Griswold & Champagne, 1985;Figure 3. Several morphological aspects of cryoglobulins may be observed on peripheral blood samples, and two among them are shown here: small lucent precipitates scattered around RBC (left), or invisible precipitates that change morphology of RBC into a 'moth-eaten' aspect (right).…”

Section: Cryofibrinogen or Relatedmentioning

confidence: 96%

Section: White Blood Cellsmentioning

confidence: 98%

“…The presence of cryoglobulin was first reported as causing erroneous WBC counts (Emori, Bluestone & Goldsberg, 1973; Taft et al. , 1973; Haeney, 1976; Gulliani, Hyun & Gabaldon, 1977), but it also leads in many instances to spuriously elevated PLT counts, and at times to altered RBC counts or Hb measurements (cf., see Fohlen‐Walter et al. , 2002).…”

Section: White Blood Cellsmentioning

confidence: 99%

“…The presence of cryoglobulin was first reported as causing erroneous WBC counts (Emori, Bluestone & Goldsberg, 1973;Taft et al, 1973;Haeney, 1976;Gulliani, Hyun & Gabaldon, 1977), but it also leads in many instances to spuriously elevated PLT counts, and at times to altered RBC counts or Hb measurements (cf., see Fohlen-Walter et al, 2002). Abnormal- ities that occur on HA are neither consistent nor related to the amount of cryoglobulin or to its nature (each type may be involved in spurious counts).…”

Section: Cryoglobulinsmentioning

confidence: 99%

“…Careful examination of the corresponding blood smears shows thin fibrils, related to fibrin strands after electron microscopic study (Figure 5). These fibrils might correspond either to cryofibrinogen, although biochemical research may be negative in some instances (Griswold & Champagne, 1985), or to a mixture of cryoglobulin and cryofibrinogen (Gulliani, Hyun & Gabaldon, 1977). However, analysis of new EDTA blood samples from the patients frequently fail to reproduce the phenomenon, hypothesizing that such particles might be the result of fibrin polymerization after a difficult venepuncture, initiating coagulation in vitro before contact of the blood with EDTA (Corberand et al.…”

Section: White Blood Cellsmentioning

confidence: 99%

See 4 more Smart Citations

Spurious counts and spurious results on haematology analysers: a review. Part II: white blood cells, red blood cells, haemoglobin, red cell indices and reticulocytes

Zandecki

Geneviève

Gérard

et al. 2007

Int J Lab Hematology

153

133

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S U M M A R YHaematology analysers provide quick and accurate results in most situations. However, spurious results, related either to platelets (part I of this report) or to other parameters from the cell blood count (CBC) may be observed in several instances. Spuriously low white blood cell (WBC) counts may be observed because of agglutination in the presence of ethylenediamine tetra-acetic acid (EDTA). Cryoglobulins, lipids, insufficiently lysed red blood cells (RBC), erythroblasts and platelet aggregates are common situations increasing WBC counts. In most of these instances flagging and/or an abnormal WBC differential scattergram will alert the operator. Several situations lead to abnormal haemoglobin measurement or to abnormal RBC count, including lipids, agglutinins, cryoglobulins and elevated WBC counts. Mean (red) cell volume (MCV) may be also subject to spurious determination, because of agglutinins, excess of glucose or salts and technological considerations. In turn, abnormality related to one measured parameter will lead to abnormal calculated RBC indices: mean cell haemoglobin content (MCHC) is certainly the most important RBC indices to consider, as it is as important as flags generated by the haematology analysers (HA) in alerting the user to a spurious result. In many circumstances, several of the measured parameters from CBC may be altered, and the discovery of a spurious change on one parameter frequently means that the validity of other parameters should be considered. Sensitive flags now allow the identification of several spurious counts, but only the most sophisticated HA have optimal flagging and more simple HA, especially those without a WBC differential scattergram, do not possess the same sensitivity for detecting anomalous results. Reticulocytes are integrated now into the CBC in many HA, and several situations may lead to abnormal counts.

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Section: Cryofibrinogen or Relatedmentioning

confidence: 96%

Section: White Blood Cellsmentioning

confidence: 98%