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Detection of frequent neutrophil misclassification by the ProCyte Dx in sick dogs and how to avoid it
E Bergstrand1, H W Tvedten2, I Lilliehöök3
1University Animal Hospital, Swedish University of Agricultural Sciences, Box 7054, 75007, Uppsala, Sweden.
Objectives:
A common and severe error in identifying neutrophils in feline blood samples by the IDEXX ProCyte Dx haematology analyser (ProCyte) has been reported. The hypothesis was that the same or similar error would be identified during analysis of canine blood samples and that white blood cell dot plot evaluation would be critical to detect and avoid erroneous results.
Materials And Methods:
Eighty-six canine blood samples collected for clinical diagnosis of hospital patients were evaluated. Differential leukocyte counts were determined by the ProCyte Dx, ADVIA 2120 and manual methods. ProCyte neutrophil percentage results were considered unacceptable if the result was 15% different than percentage results from both ADVIA 2120 and manual counts. ProCyte WBC dot plots and instrument flags were evaluated for correctness.
Results:
The ProCyte neutrophil counts were unacceptably lower than the ADVIA 2120 and manual neutrophil counts in 13 samples (15% of 86 samples). Neutrophils misclassified by the instrument were erroneously classified as monocytes and/or lymphocytes. All these samples were from patients with systemic inflammation. The error could be eliminated by rejecting results from samples with incorrect separation of cell clusters in the ProCyte WBC dot plots.
Clinical Significance:
The ProCyte neutrophil count error with canine blood samples is common, severe and might affect clinical decisions. Operators of the instrument must evaluate white blood cell dot plots for correctness to avoid the error.
Insights
The IDEXX ProCyte Dx analyser commonly misidentifies neutrophils in canine blood, classifying them as monocytes or lymphocytes. Evaluating white blood cell dot plots is crucial for accurate canine neutrophil counts.
Area of Science:
- Veterinary Hematology
- Clinical Pathology
- Diagnostic Cytometry
Background:
- A significant error in neutrophil identification by the IDEXX ProCyte Dx haematology analyser has been noted in feline blood samples.
- This study investigated whether a similar neutrophil misclassification error occurs in canine blood samples using the same analyser.
Purpose of the Study:
- To determine if the IDEXX ProCyte Dx analyser exhibits neutrophil misclassification errors in canine blood samples.
- To assess the utility of white blood cell dot plot evaluation in detecting and preventing such erroneous results.
Main Methods:
- Eighty-six canine blood samples were analyzed using the IDEXX ProCyte Dx, ADVIA 2120, and manual counting methods.
- ProCyte Dx neutrophil counts were deemed unacceptable if they differed by more than 15% from both ADVIA 2120 and manual counts.
- Instrument flags and white blood cell dot plots from the ProCyte Dx were critically reviewed.
Main Results:
- The ProCyte Dx analyser yielded unacceptable neutrophil counts in 15% (13/86) of canine samples, showing counts significantly lower than reference methods.
- Misclassified neutrophils were erroneously identified as monocytes and/or lymphocytes, particularly in samples from patients with systemic inflammation.
- Reviewing ProCyte Dx white blood cell dot plots allowed for the identification and potential elimination of these erroneous results.
Conclusions:
- The IDEXX ProCyte Dx analyser exhibits a common and severe neutrophil misclassification error in canine blood samples, potentially impacting clinical decisions.
- Veterinary professionals operating the ProCyte Dx must meticulously evaluate white blood cell dot plots to ensure the accuracy of canine neutrophil counts and avoid diagnostic errors.
