Tsuda T, Fujii M, Shimizu E, Tsujimoto M, Okamoto Y, Ota K, Maeda J
Division of Laboratory Medicine, Wakayama Medical College.
Rinsho Ketsueki. 1990 Jan;31(1):23-8.
Spuriously low electronic white-cell count was obtained on EDTA-anticoagulated blood from a 54-year-old male suffering from liver cell carcinoma. In an attempt to understand better the phenomenon, in vitro studies were performed. The blood smear anticoagulated with EDTA revealed remarkable agglutinations of leukocytes, mainly neutrophils but not lymphocytes. The EDTA-treated blood showed maximal leukocytes-agglutinations at room temperature but no agglutination at 37 degrees C. The agglutinated leukocytes, moreover, were dispersed by incubating the blood at 37 degrees C. Although agglutination occurred in some degree in the blood anticoagulated with Na-heparin or Na3-citrate, it was much less pronounced compared to the EDTA-treated blood. Remarkable leukocytes-agglutinations were induced when EDTA-anticoagulated blood from healthy donor was mixed with serum from the patient at room temperature. These results suggest that the phenomenon of in vitro leukocyte agglutination and consequent pseudoleukocytopenia is due to leukocyte agglutinin in serum from the patient. The mechanisms were discussed comparing with pseudothrombocytopenia caused by platelet agglutinin.
一名54岁肝细胞癌男性患者的乙二胺四乙酸（EDTA）抗凝血液中出现了假性低电子白细胞计数。为了更好地理解这一现象，进行了体外研究。用EDTA抗凝的血涂片显示白细胞有明显凝集，主要是中性粒细胞而非淋巴细胞。经EDTA处理的血液在室温下白细胞凝集最为明显，但在37℃时无凝集。此外，将血液在37℃孵育可使凝集的白细胞分散。虽然用钠肝素或柠檬酸钠抗凝的血液也有一定程度的凝集，但与经EDTA处理的血液相比，其凝集程度要轻得多。当健康供者的EDTA抗凝血液在室温下与患者血清混合时，会诱导出明显的白细胞凝集。这些结果表明，体外白细胞凝集及由此导致的假性白细胞减少现象是由于患者血清中的白细胞凝集素所致。并与由血小板凝集素引起的假性血小板减少症相比较，对其机制进行了讨论。
