The inflammation meter: Novel technology to detect the presence of infection/inflammation in patients without leukocytosis but with increased leukocyte adhesiveness/aggregation

Objectives: To reveal the presence of infection/inflammation in patients wi th relatively normal white blood cell count (WBCC) by using the leukocyte a dhesiveness/ aggregation test (LAAT). Methods: The LAAT was performed by us ing a simple slide test and image analysis (Inflamet(TM)), the WBCC, by an electronic cell analyzer, C-reactive protein, by Laser nephelometry and CD1 1b/ CD18 by whole blood flow cytometry. Results: Forty out of a cohort of 1 21 patients with nonviral acute febrile illness had a WBCC within normal li mits. The intensity of the inflammatory response in these individuals as ju dged by either C-reactive protein, or fibrinogen concentrations, erythrocyt e sedimentation or polymorphonuclear leukocyte CD11b/CD18 expression was si milar to that observed in patients with a leukocytic response. Our present finding that 63% out of the group with documented infection/inflammation an d no leukocytosis had a significantly increased LAAT suggest that the lack of leukocytosis is in part a pseudoleukopenia, or is associated with some d egree of uncompensated tissue leukostasis. Conclusions: The lack of a leuko cytic response in a patient with nonviral infection/inflammation is by no m eans a sign of a less inflammatory response. The increased state of leukocy te adhesiveness/aggregation might help to disclose the presence of inflamma tion in these individuals. Copyright (C) 2000 S. Karger AG. Basel.