Prospective validation of an automatic reflex test for identifying spurious elevations of mean corpuscular haemoglobin concentration due to the presence of cold agglutinins
Articolo
Data di Pubblicazione:
2021
Citazione:
Prospective validation of an automatic reflex test for identifying spurious elevations of mean corpuscular haemoglobin concentration due to the presence of cold agglutinins / F. Stefania Falvella, M. Chibireva, M. Panteghini. - In: SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION. - ISSN 0036-5513. - 81:7(2021), pp. 598-600. [10.1080/00365513.2021.1959051]
Abstract:
Cold agglutinins (CA) in blood may cause false reduction in red blood cell (RBC) count and false
increases of RBC indices, such as mean corpuscular haemoglobin concentration (MCHC). Preheating at
37 C for 2 h is used to overcome this problem. We previously proposed the integration in a total
laboratory automation (TLA) setting of a customized reflex test in the presence of MCHC >385 g/L for
identifying spurious elevations due to CA. Here, we prospectively evaluate this approach after its introduction in our clinical practice. We evaluated 73 consecutive blood samples from 34 adult patients.
Short heating (<1 min) at 41 C using the reticulocyte channel of Sysmex XN-9000 platform was followed by calculation of optical parameters by the instrument software to ensure quick solution of the CA-dependent problems. After the reflex test in the reticulocyte channel, MCHC dropped below 385 g/L in 50 samples. The reflex markedly corrected the RBC number in eight samples obtained from three patients with CA condition. Two samples from markedly anaemic patients had low blood haemoglobin and RBC count before and after reflex. The remaining 13 samples were obtained from 12 patients, most of whom were on antiretroviral therapy or suffered severe electrolyte disorders, known conditions associated to increased MCHC. The implementation of the proposed automatic reflex by reticulocyte channel on the Sysmex XN-9000 platform in a TLA setting may solve the problem of spuriously high MCHC due to RBC agglutination for CA in a few minutes instead of waiting hours for sample preheating.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Cold agglutinins; MCHC; optical parameters; haematology analysers; laboratory automation
Elenco autori:
F. Stefania Falvella, M. Chibireva, M. Panteghini
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