Cold-Reactive Erythrocyte Agglutination Causing Analytical Interference in Automated Hematology: A Case Report
A Case Report
DOI:
https://doi.org/10.33005/jdiversemedres.v3i8.369Keywords:
cold-reactive erythrocyte agglutination, peripheral blood smear, specimen warmingAbstract
Cold-reactive erythrocyte agglutination is an important cause of analytical interference in automated hematology testing. We report a 55-year-old man with severe anemia, leukocytosis, thrombocytopenia, and suspected hematologic malignancy in whom hematological parameters changed substantially following specimen warming. The blood specimen had a sandy appearance and was incubated at 37°C before repeat analysis. Before incubation, WBC was 32,270/µL, RBC 0.29 × 10⁶/µL, hemoglobin 8.3 g/dL, hematocrit 2.8%, MCH 283.3 pg, and MCHC 295.8 g/dL. Following incubation, WBC was 19,630/µL, RBC 1.93 × 10⁶/µL, hemoglobin 6.1 g/dL, hematocrit 17.8%, MCH 31.7 pg, and MCHC 34.3 g/dL. Peripheral blood smear demonstrated erythrocyte agglutination and approximately 10% immature cells resembling myeloid blasts. This case highlights the importance of recognizing cold-reactive erythrocyte agglutination, appropriate specimen warming, and peripheral blood smear examination to improve interpretation of automated hematology results.Downloads
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