INSTRUMENTAL REPORTS AND EFFECT OF ANTICOAGULANTS IN A CASE OF NEUTROPHIL AGGLUTINATION IN-VITRO

Citation
M. Galifi et al., INSTRUMENTAL REPORTS AND EFFECT OF ANTICOAGULANTS IN A CASE OF NEUTROPHIL AGGLUTINATION IN-VITRO, Haematologica, 78(6), 1993, pp. 364-370
Citations number
22
Categorie Soggetti
Hematology
Journal title
ISSN journal
03906078
Volume
78
Issue
6
Year of publication
1993
Pages
364 - 370
Database
ISI
SICI code
0390-6078(1993)78:6<364:IRAEOA>2.0.ZU;2-M
Abstract
Background. The aim of this study was to investigate a case of E-DTA-i nduced polymorphonuclear leukocyte (PMN) agglutination in vitro on Bay er Technicon H1. Coulter Counter STKS and STKR analyzers. Methods. Ve nous whole blood was anticoagulated with K-3 . EDTA, sodium citrate, l ithius heparinate, acid citrate dextrose (ACD) and with two other anti coagulant mixtures containing citric acid-theophylline-adenosine-dipyr idamole (CTAD) or citrate-pyridoxal 5'-phosphate-tris (CPT). Results. PMN agglutination, EDTA - but not temperature - dependent, was found b y mere chance in an asymptomatic 48-year-old Caucasian male who did no t show detectable PMN antibodies. Pseudoneutropenia without pseudoleuk openia was registered on HI exclusively in EDTA anticoagulated blood with a characteristic higher density PMN population on the BASO cytogr am. Spuriously low white blood cell (WBC) counts and pseudoneutropenia appeared on STKR and STI(S in E-DTA anticoagulated blood, but signals on PMN agglutination were unsatisfactory. Accurate total and differen tial WBC counts were obtained in CTAD or CPT anticoagulated samples on the three analyzers. Heparin was the worst choice because it induced pseudothrombocytopenia and pseudoleukocytosis on STKR and STKS. Conclu sions. Since PMN agglutination was not observed on peripheral smears a nd was undetected on EDTA anticoagulated samples processed immediately by H1, the presence in vivo of PMN clumps should be excluded. Furthe r hematological investigations will demonstrate in the long run whethe r the observed PMN agglutination in vitro is a transient occurrence in an apparently healthy subject not taking drugs at the time of observa tion.