Stress in the emergency room: A simple leukocyte to glass adhesion test provides a diagnostic tool to differentiate between stress and infection/inflammation related leukocytosis

In order to discriminate between stress-induced leukocytosis and an infecti on/inflammation-related one, we have used a modified leukocyte adhesiveness /aggregation test (LAAT) to examine the adhesive properties of white blood cells towards glass surfaces. A highly significant p < 0.00001) difference was noted between the percent of aggregated cells found in a group of patie nts with various conditions of infection/inflammation (22.9 +/- 6.4%) and t hose with stress (7.5 +/- 1.4%). The corresponding difference between the t otal white blood cell count in the peripheral blood of these two groups (16 ,547 +/- 3289 and 14,114 +/- 4898 cells per mm(3), respectively) was not si gnificant. The difference in total leukocytes adhered to the glass in the t wo groups (445 +/- 136 vs 228 +/- 72 cells per high power field) that were determined along the slide was also highly significant (p < 0.00001). Thus, a simple glass slide technique might be of clinical utility for an effecti ve, rapid and inexpensive means of discrimination between stress and infect ion/inflammation related leukocytosis. Copyright (C) 1999 John Wiley & Sons , Ltd.