CORRECTION OF SPURIOUS BLOOD-CELL COUNTS IN A PATIENT WITH CRYOGLOBULINEMIA REVERSED BY THE USE OF CITRATE-ANTICOAGULATED BLOOD

Cryoglobulins may interfere with automated cell counting when proteins precipitate or blood cells aggregate. This results in spurious platel et or leukocyte counts, false values for red blood cell parameters and abnormal scattergrams. Usually it can be reversed by warming blood sp ecimens to 37 degrees C. We describe the case of a 63-year-old woman w ith autoimmune disease in whom the diagnosis of cryoglobulinemia was s uspected due to typical changes in blood cell counts. Artifacts were r esistant to warming of the sample to 37 degrees C in both EDTA-and hep arin-anticoagulated blood specimens. In contrast, the use of citrate a s anticoagulant allowed correct measurements. This case underlines the role of assessment of blood counts in the detection of cryoglobulinem ia. Correct measurements of automated blood counts in cryoglobulinemia may depend on the use of alternative anticoagulants.