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Related Experiment Video

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Macropolycytes as a sepsis biomarker.

M P Barros Pinto1

  • 1Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.

Morphologie : Bulletin De L'Association Des Anatomistes
|November 10, 2024
PubMed
Summary

Macropolycytes, large red blood cells, were misidentified as monocytes in a kidney transplant patient experiencing septic shock. These cells may serve as crucial biomarkers for sepsis detection.

Keywords:
MDWMacropolycytesSepsis

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Area of Science:

  • Hematology
  • Transplant Medicine
  • Critical Care Medicine

Background:

  • Sepsis is a life-threatening condition often complicating organ transplantation.
  • Accurate and timely diagnosis of sepsis is critical for patient outcomes.
  • Automated hematology analyzers can sometimes misinterpret atypical cell morphologies.

Purpose of the Study:

  • To investigate a case of septic shock in a kidney transplant recipient.
  • To identify the cause of abnormal automated blood count findings.
  • To highlight the potential role of macropolycytes as sepsis biomarkers.

Main Methods:

  • Analysis of a 16-year-old male kidney transplant patient with septic shock.
  • Review of automated full blood count (FBC) results, including white blood cell scatter plots.
  • Performance of peripheral blood film (PBF) examination for detailed cell morphology assessment.

Main Results:

  • Automated FBC indicated monocytosis with overlapping neutrophil and monocyte populations.
  • A "MO blast" flag suggested immature myeloid cells.
  • Peripheral blood film revealed the presence of macropolycytes, which were misclassified as monocytes by the analyzer.

Conclusions:

  • Macropolycytes can be erroneously identified as monocytes by automated analyzers.
  • Macropolycytes may represent a significant, yet overlooked, biomarker in sepsis.
  • Careful peripheral blood film review is essential when automated flags suggest atypical cell populations, especially in immunocompromised patients.