A Clue to Discovering Unstable Hemoglobin Variants via Abnormal WBC Differential Scattergrams Using the Sysmex Automated Hematology Analyzer
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Incidentally, hemoglobin (Hb) variants can be detected using HbA1c tests in clinical laboratories. We found 38 patients with Hb variants after reviewing a total of 29,398 HbA1c test results from January 2017 to December 2017. While reviewing the complete blood count results of the patients (N=36) using the Sysmex XN-9000 analyzer (Sysmex, Japan), 35 patients were flagged as unremarkable with respect to differential white blood cell (WBC) counts. However, 1 patient with a normal WBC count did not obtain a differential WBC count while being flagged for an abnormal WBC scattergram in the white blood cell differential (WDF) channel. The WBC histogram showed an abnormally low fluorescent signal in the WDF channel; however, the differential WBC count was normal upon microscopic examination. After testing the patient's buffy coat suspended in normal saline and removing red blood cells (RBCs), the WBC scattergram and differential WBC count returned to normal. This finding suggests that the presence of a patient's RBCs may affect WBC scattergrams and Hb variants may interfere with the fluorescent dye in the differential WBC count. Therefore, when an abnormal WBC scattergram with an abnormally low fluorescent signal is encountered on the Sysmex XN-9000 analyzer, the presence of an Hb variant can be suspected.
Abstract
Incidentally, hemoglobin (Hb) variants can be detected using HbA1c tests in clinical laboratories. We found 38 patients with Hb variants after reviewing a total of 29,398 HbA1c test results from January 2017 to December 2017. While reviewing the complete blood count results of the patients (N=36) using the Sysmex XN-9000 analyzer (Sysmex, Japan), 35 patients were flagged as unremarkable with respect to differential white blood cell (WBC) counts. However, 1 patient with a normal WBC count did not obtain a differential WBC count while being flagged for an abnormal WBC scattergram in the white blood cell differential (WDF) channel. The WBC histogram showed an abnormally low fluorescent signal in the WDF channel; however, the differential WBC count was normal upon microscopic examination. After testing the patient's buffy coat suspended in normal saline and removing red blood cells (RBCs), the WBC scattergram and differential WBC count returned to normal. This finding suggests that the presence of a patient's RBCs may affect WBC scattergrams and Hb variants may interfere with the fluorescent dye in the differential WBC count. Therefore, when an abnormal WBC scattergram with an abnormally low fluorescent signal is encountered on the Sysmex XN-9000 analyzer, the presence of an Hb variant can be suspected.
참고문헌 (6)
- Thom CS, "Hemoglobin variants : biochemical properties and clinical correlates", Cold Spring Harb Perspect Med, 3, pp.a011858~ (2013)
- 박설희, "Diagnostic Utility of Serum Glycated Albumin for Diabetes Mellitus and Its Correlation With Hyperlipidemia", Annals of Laboratory Medicine, 36(4), pp.306~312 (2016), 대한진단검사의학회
- Rosetti M, "A rare case of hemoglobin Leiden interfering with the DIFF channel of Sysmex XE-2100", Scand J Clin Lab Invest, 75, pp.436~437 (2015)
- Rosetti M, "Serendipitous detection of hemoglobin G-Ferrara variant with Sysmex DIFF channel", Clin Biochem, 49, pp.192~193 (2016)
- Mongelli F, "A rare and unstable hemoglobin variant, Hb M Dothan β 25", 26(-GTG), detected by the anomalous cytogram on Sysmex XE-2100, 2016, pp.54, e31~e33
- Teixeira C, "Automated detection of unstable hemoglobin variants by Sysmex XE-Series analyzers", Clin Chem Lab Med, 55, pp.e243~e246 (2017)