RT Journal Article
SR Electronic
T1 Short preheating at 41°C leads to a red blood cells count comparable to that in RET channel of Sysmex analysers in samples showing cold agglutination
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 729
OP 734
DO 10.1136/jclinpath-2017-204954
VO 71
IS 8
A1 La Gioia, Antonio
A1 Fumi, Maurizio
A1 Fiorini, Fabiana
A1 Pezzati, Paola
A1 Balboni, Fiamma
A1 Bombara, Maria
A1 Marini, Alessandra
A1 Pancione, Ylenia
A1 Solarino, Leonardo
A1 Marchese, Elisa
A1 Sale, Silvia
A1 Rocco, Vincenzo
A1 Fiorini, Marcello
YR 2018
UL http://jcp.bmj.com/content/71/8/729.abstract
AB Aims The presence of cold agglutinin in blood samples can cause a spontaneous agglutination of red blood cells (RBCs) when low temperature occurs. This phenomenon causes a spurious lowering of RBC count on the automated haematological analysers that are detected by incongruous values (≥370 g/L) of the mean cellular haemoglobi concentration (MCHC). A preheating at 37°C can remove the RBC agglutination generally resulting in a reliable count. It has been reported that the same result can be reached by using the optical reticulocyte (RET) channel of Sysmex analysers where the RBC count is not influenced by the presence of cold agglutinin. This study aims to evaluate these data in a larger population, with regard to environmental conditions on Sysmex analysers. We have also evaluated the influence of different thermal pretreatments on the RBC count.Methods This study was performed on 96 remnants of peripheral blood samples (48 with MCHC in normal range and 48 with MCHC>370 g/L) which have been analysed in different preanalytical conditions on the Sysmex analysers.Results A preheating of samples at 41°C for 1 min leads to a reversibility of the cold agglutination comparable to the one observed in the RET channel and yields better results compared with 37°C for 2 hours.Conclusions None of described procedures assure the complete cold agglutination reversibility in every case. Consequently, since the haematological analysers not yet provide reliable parameters to confirm the complete resolution of agglutination, further verification of RBC count accuracy needs to be performed.