Unreliable Automated Complete Blood Count Results: Causes, Recognition, and Resolution
2
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Automated hematology analyzers generate accurate complete blood counts (CBC) results on nearly all specimens. However, every laboratory encounters, at times, some specimens that yield no or inaccurate result(s) for one or more CBC parameters even when the analyzer is functioning properly and the manufacturer’s instructions are followed to the letter. Inaccurate results, which may adversely affect patient care, are clinically unreliable and require the attention of laboratory professionals. Laboratory professionals must recognize unreliable results, determine the possible cause(s), and be acquainted with the ways to obtain reliable results on such specimens. We present a concise overview of the known causes of unreliable automated CBC results, ways to recognize them, and means commonly utilized to obtain reliable results. Some examples of unreliable automated CBC results are also illustrated. Pertinent analyzer-specific information can be found in the manufacturers’ operating manuals.
Abstract
Automated hematology analyzers generate accurate complete blood counts (CBC) results on nearly all specimens. However, every laboratory encounters, at times, some specimens that yield no or inaccurate result(s) for one or more CBC parameters even when the analyzer is functioning properly and the manufacturer’s instructions are followed to the letter. Inaccurate results, which may adversely affect patient care, are clinically unreliable and require the attention of laboratory professionals. Laboratory professionals must recognize unreliable results, determine the possible cause(s), and be acquainted with the ways to obtain reliable results on such specimens. We present a concise overview of the known causes of unreliable automated CBC results, ways to recognize them, and means commonly utilized to obtain reliable results. Some examples of unreliable automated CBC results are also illustrated. Pertinent analyzer-specific information can be found in the manufacturers’ operating manuals.
참고문헌 (86)
- Cornbleet J, "Spurious results from automated hematology cell counters", Lab Med, 14, pp.509~514 (1983)
- Zandecki M, "Spurious counts and spurious results on haematology analysers: a review. Part I: platelets", Int J Lab Hematol, 29, pp.4~20 (2007)
- Zandecki M, "Spurious counts and spurious results on haematology analyzers: a review. Part II: white blood cells, red blood cells, hemoglobin, red cell indices and reticulocytes", Int J Lab Hematol, 29, pp.21~41 (2007)
- "Ann Biol Clin(Paris)", 2012, 155~168
- De la Salle B, "Pre-and postanalytical errors in haematology", Int J Lab Hematol, 41(S1), pp.170~176 (2019)
- Nicholls PD, "An improved method for obtaining reliable blood counts with hyperlipaemic samples on an automated particle counter", Med Lab Sci, 40, pp.397~400 (1983)
- "CAP Today. In: Savage RA, ed. Q & A column" (2004)[URL]
- Gulati GL, "Blood cells: morphology and clinical relevance" (2021), American Society of Consultant Pharmacists Press
- Zeng SG, "A simple, fast correction method of triglyceride interference in blood hemoglobin automated measurement", J Clin Lab Anal, 27, pp.341~345 (2013)
- "What CBC parameters are affected when the specimen is lipemic?" (2016)[URL]
- Zhao XC, "Severe hyperlipemia-induced pseudoerythrocytosis-implication for misdiagnosis and blood transfusion : A case report and literature review", World J Clin Cases, 8, pp.4595~4602 (2020)
- Lippi G, "Haemolysis : an overview of the leading cause of unsuitable specimens in clinical laboratories", Clin Chem Lab Med, 46, pp.764~772 (2008)
- Lippi G, "Influence of in vitro hemolysis on hematological testing on Advia 2120", Int J Lab Hematol, 34, pp.179~184 (2012)
- de Jonge G, "Interference of in vitro hemolysis complete blood count", J Clin Lab Anal, 32, pp.e22396~ (2018)
- "Interference in lab assays" (2017)[URL]
- Topic A, "Effect of cold agglutinins on red blood cell parameters in a trauma patient: a case report", Biochem Med(Zagreb), 28, pp.031001~ (2018)
- 임정훈, "Effects of Cold Agglutinin on the Accuracy of Complete Blood Count Results and Optimal Sample Pretreatment Protocols for Eliminating Such Effects", Annals of Laboratory Medicine, 38(4), pp.371~374 (2018), 대한진단검사의학회
- Antonio La Gioia, "Eliminating or Minimizing the Effects of Cold Agglutinins on the Accuracy of Complete Blood Count Results", Annals of Laboratory Medicine, 39(5), pp.499~500 (2019), 대한진단검사의학회[DOI]
- Hillyer CD, "EDTA-dependent leukoagglutination", Am J Clin Pathol, 94, pp.458~461 (1990)
- Yang D, "Leukocyte aggregation in vitro as a cause of pseudoleukopenia", Lab Med, 39, pp.89~91 (2008)
- Lesesve JF, "EDTA-dependent lymphoagglutination in a patient with non-Hodgkin lymphoma", Int J Lab Hematol, 29, pp.221~224 (2007)
- Walradth EA, "Lymphocyte aggregation in low-grade B-cell lymphoma", Lab Med, 52, pp.e133~e136 (2021)
- Goyal P, "Cold-induced pseudoneutropenia in human immunodeficiency virus infection: first case report and review of related articles", Indian J Hematol Blood Transfus, 30(suppl. 1), pp.148~150 (2014)
- Sultan S, "In vitro leukoagglutination : A rare hematological cause of spurious leukopenia", Acta Med Iran, 55, pp.408~410 (2017)
- Chen L, "Detection of EDTA-induced pseudo-leukopenia using automated hematology analyzer with VCS technology", Clin Chem Lab Med, 56, pp.e204~e206 (2018)
- Hoffmann JJ, "EDTA-induced pseudo-neutropenia resolved with kanamycin", Clin Lab Haematol, 23, pp.193~196 (2001)
- Anand M, "Pseudoleukopenia due to ethylenediaminetetraacetate-induced leukoagglutination in a case of hypovolemic shock", Indian J Crit Care Med, 16, pp.113~114 (2012)
- Schuff-Werner P, "Pseudo-thrombocytopenia (PTCP). A challenge in the daily laboratory routine?", J Lab Med, 44, pp.295~304 (2020)
- Lardinois B, "Pseudothrombocytopenia—a review on causes, occurrence and clinical implications", J Clin Med, 10, pp.594~ (2021)
- Abal CC, "Pseudothrombocytopenia by ethylenediaminetetraacetic acid can jeopardize patient safety–report", EJIFCC, 31, pp.65~69 (2020)
- Bartels PC, "Screening for EDTA-dependent deviations in platelet counts and abnormalities in platelet distribution histograms in pseudothrombocytopenia", Scand J Clin Lab Invest, 57, pp.629~636 (1997)
- Baccini V, "Platelet counting: ugly traps and good advice. Proposals from the French-Speaking Cellular Hematology Group (GFHC)", J Clin Med, 9, pp.808~ (2020)
- Solanki DL, "Spurious leukocytosis and thrombocytopenia. A dual phenomenon caused by clumping of platelets in vitro", JAMA, 250, pp.2514~2515 (1983)
- Savage RA, "Pseudoleukocytosis due to EDTA-induced platelet clumping", Am J Clin Pathol, 81, pp.317~322 (1984)
- Gulati GL, "Using a vortex to disaggregate platelet clumps", Lab Med, 28, pp.665~667 (1997)
- Lombarts AJ, "Recognition and prevention of pseudothrombocytopenia and concomitant pseudoleukocytosis", Am J Clin Pathol, 89, pp.634~639 (1988)
- Roberts WL, "Overestimation of hemoglobin in a patient with an IgA-kappa monoclonal gammopathy", Arch Pathol Lab Med, 124, pp.616~618 (2000)
- Shastry IK, "Paraprotein-induced factitious results on an automated hematology analyzer", Br Biomed Bull, 2, pp.187~191 (2014)
- Brouet JC, "Biologic and clinical significance of cryoglobulins. A report of 86 cases", Am J Med, 57, pp.775~788 (1974)
- Fohlen-Walter A, "Laboratory identification of cryoglobulinemia from automated blood cell counts, fresh blood samples, and blood films", Am J Clin Pathol, 117, pp.606~614 (2002)
- Patel KJ, "Pseudoleucocytosis and pseudothrombocytosis due to cryoglobulinaemia", J Clin Pathol, 40, pp.120~121 (1987)
- Gulliani GL, "Falsely elevated automated leukocyte counts on cryoglobulinemic and", or cryofibrinogenemic blood samples, 1977, pp.8, 14~16
- Abela M, "Pseudoleucocytosis due to cryoglobulinaemia", J Clin Pathol, 33, pp.796~ (1980)
- Keshgegian AA, "(Lankenau Hospital case conference)Mixed cryoglobulinemia causing pseudoleukocytosis", Clin Chem, 31, pp.769~773 (1985)
- Gulati GL, "Interference by cryoproteins in the blood with automated CBCs", Lab Med, 26, pp.138~142 (1995)
- Geara A, "Pseudoleukocytosis secondary to hepatitis C-associated cryoglobulinemia : a case report", J Med Case Rep, 3, pp.91~ (2009)
- Kakkar N, "Spurious rise in the automated platelet count because of bacteria", J Clin Pathol, 57, pp.1096~1097 (2004)
- Latif S, "Spurious automated platelet count. Enumeration of yeast forms as platelets by the cell-DYN 4000", Am J Clin Pathol, 120, pp.882~885 (2003)
- Kim HR, "Effects of bacteria and yeast on WBC counting in three automated hematology counters", Ann Hematol, 87, pp.557~562 (2008)
- Branda JA, "Effects of yeast on automated cell counting", Am J Clin Pathol, 126, pp.248~254 (2006)
- Lesesve JF, "Peripheral blood candidosis infection leading to spurious platelet and white blood cell counts", Int J Lab Hematol, 31, pp.572~576 (2009)
- Crabbe G, "Artefactually-normal automated platelet counts due to malaria-infected RBC", Clin Lab Haematol, 24, pp.179~182 (2002)
- Morse EE, "Increased electronic mean corpuscular volume induced by marked hyperglycemia", Ann Clin Lab Sci, 11, pp.184~187 (1981)
- de Baca ME, "Effects of storage of blood at room temperature on hematologic parameters measured on Sysmex XE-2100", Lab Med, 37, pp.28~36 (2006)
- Buonocore R, "Spurious hyperglycaemia impairs automated leucocyte counting. A pilot study with two different haematological analysers", Blood Transfus, 13, pp.656~661 (2015)
- Watson KR, "Data regarding blood drawing sites in patients receiving intravenous fluids", Am J Clin Pathol, 79, pp.119~121 (1983)
- Gulati GL, "An unusual WBC scattergram and its possible causes", Lab Med, 27, pp.398~402 (1996)
- Whiteway AJ, "Artefactual elevation of an automated white cell count following femoral vein puncture", Clin Lab Haematol, 21, pp.65~68 (1999)
- Maeda K, "Pseudoleukocytosis due to fibrin strands", Am J Clin Pathol, 74, pp.497~ (1980)
- Kumar A, "Spurious leukocyte counts and an abnormal histogram pattern due to fibrin clumps", Indian J Hematol Blood Transfus, 34, pp.785~787 (2018)
- Akwari AM, "Spuriously elevated platelet counts due to microspherocytosis", Am J Clin Pathol, 77, pp.220~221 (1982)
- Sapanara NL, "Spurious thrombocytosis in a burn patient", Lab Med, 35, pp.98~100 (2004)
- Tantanate C, "Spuriously high platelet counts by various automated hematology analyzers in a patient with disseminated intravascular coagulation", Clin Chem Lab Med, 53, pp.e257~e259 (2015)
- Zahid MF, "Spurious thrombocytosis in the setting of hemolytic anemia and microcytosis secondary to extensive burn injury", Turk J Haematol, 35, pp.205~206 (2018)
- Velizarova M, "Pseudothrombocytosis in a patient with heterozygous beta-thalassemia", Int J Health Sci Res, 8, pp.297~299 (2018)
- Slota AA, "Pseudo-thrombocytosis caused by extreme microcytosis in a patient with alpha thalassemia trait", Indian J Hematol Blood Transfus, 36, pp.779~780 (2020)
- Pan LL, "Enhanced accuracy of optical platelet counts in microcytic anemia", Lab Med, 45, pp.32~36 (2014)
- Booth F, "Resistance to lysis of erythrocytes containing haemoglobin C—detected in a differential white cell counting system", J Clin Pathol, 36, pp.816~818 (1983)
- Seigneurin D, "Interference of hyperleukocytosis on Coulter Counter Model S blood counts : methods for correction", Biomed Pharmacother, 37, pp.401~404 (1983)
- "Lipemia and hyperleukocytosis can lead to CBC errors", MLO Med Lab Obs, 48, pp.64~ (2016)
- Hatzipantelis ES, "Hereditary giant platelet disorder presented as pseudothrombocytopenia", Eur J Haematol, 67, pp.330~331 (2001)
- Wang L, "Giant platelets induce double interference in complete blood count", Ann Clin Lab Sci, 49, pp.554~556 (2019)
- Ballard HS, "Cytoplasmic fragments causing spurious platelet counts in hairy cell leukemia : ultrastructural characterization", Arch Intern Med, 141, pp.942~944 (1981)
- Hammerstrøm J, "Spurious platelet counts in acute leukaemia with DIC due to cell fragmentation", Clin Lab Haematol, 14, pp.239~243 (1992)
- van der Meer W, "Pseudoplatelets : a retrospective study of their incidence and interference with platelet counting", J Clin Pathol, 56, pp.772~774 (2003)
- Kakkar N, "Cytoplasmic fragments of leukaemic cells masquerading as platelets in an automated haematology analyser", J Clin Pathol, 58, pp.224~ (2005)
- Gulati GL, "Platelet satellitosis : a case report with laboratory characterization and quantitative evaluation", Ann Clin Lab Sci, 9, pp.109~115 (1979)
- Bobba RK, "Platelet satellitism as a cause of spurious thrombocytopenia", Blood, 119, pp.4100~ (2012)
- Kishore M, "Platelet satellitism : A culprit for spurious thrombocytopenia", Br Biomed Bull, 2, pp.230~234 (2014)
- Tantanate C, "Vortex mixing to alleviate pseudothrombocytopenia in a blood specimen with platelet satellitism and platelet clumps", Clin Chem Lab Med, 59, pp.e189~e191 (2021)
- Constantino BT, "Nucleated RBCs—significance in the peripheral blood film", Lab Med, 31, pp.223~229 (2000)
- de Keijzer MH, "Automated counting of nucleated red blood cells in blood samples of newborns", Clin Lab Haematol, 24, pp.343~345 (2002)
- Pipitone S, "Comparison of nucleated red blood cell count with four commercial hematological analyzers", Clin Chem Lab Med, 53, pp.e315~e318 (2015)
- Whitby L, "The significance of megakaryocytes in the peripheral circulation", Blood, 3, pp.934~938 (1948)
- Ku NK, "Unusual finding of a megakaryocyte in a peripheral blood smear", Blood, 130, pp.2573~ (2017)
- Garg N, "Megakaryocytes in peripheral blood smears", Turk J Haematol, 36, pp.212~213 (2019)
