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Spurious Low WBC Count from Sysmex XN3000: a Case Report.
Clinical Laboratory
|November 12, 2019
Summary
A liver transplant patient experienced a falsely low white blood cell (WBC) count due to pseudoleukopenia. Diluting the blood sample corrected the count, confirming it as a viable method for accurate WBC assessment.
Area of Science:
- Hematology
- Transplant Medicine
- Clinical Pathology
Background:
- Presents a case of a 56-year-old liver transplant recipient with liver cancer.
- Routine blood tests indicated a significant, spurious decrease in white blood cell (WBC) count.
Observation:
- Observed WBC count was 0.03 x 10^9/L, a drastic drop from the previous 19.30 x 10^9/L.
- Blood smear analysis revealed a higher WBC count than automated analyzer results, with no cell aggregation.
Findings:
- Diluting the blood sample 1:7 with DCL (Diluent for Cell Counting) resolved the discrepancy.
- The diluted automated result aligned with the manual blood smear findings.
Implications:
- Recommends dilution mode as a potential solution for pseudoleukopenia when White Cell Normal flag (WNR) and White Cell Differential flag (WDF) discordance occurs.
- Highlights the importance of manual smear review in cases of automated hematology analyzer discrepancies.
