Inaba Tohru, Shimomoto Bunta, Yuki Yoichi, Okumura Keita, Nishimura Hiroshi, Koshino Katsuhiro, Nobori Shuji, Wada Atsushi, Fujita Naohisa
Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
Faculty of Clinical Laboratory, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
Ann Clin Lab Sci. 2017 Sep;47(5):581-585.
We encountered blood specimens from a patient with MYH9 related diseases, which gave falsely high white blood cell (WBC) counts during laboratory analysis using Sysmex XN-series automated hematology analyzers. This overcount was revealed to be caused by the overlapping of platelet (PLT) distribution with the WBC area in the WNR channel, which was used for routine WBC count with the XN-series. On the other hand, the WBC count obtained through the WDF channel of the XN-series seemed more accurate in such a case. We then created and introduced alert message settings for such rare but critical specimens, which gives a warning when the discrepancy in WBC counts between the WNR and WDF channels is higher than 1.0×10/L. By using the alert message setting, we were able to detect some specimens which gave falsely high WBC counts with the routine WNR channel from three other cases of giant PLTs. In conclusion, our alert message setting seems useful in avoiding false reporting of WBC count due to abnormal cells, including giant PLTs.
我们遇到了一名患有MYH9相关疾病患者的血液标本，在使用Sysmex XN系列自动血液分析仪进行实验室分析时，该标本的白细胞（WBC）计数出现了假性升高。结果发现，这种计数过高是由于在XN系列用于常规白细胞计数的WNR通道中，血小板（PLT）分布与白细胞区域重叠所致。另一方面，在这种情况下，通过XN系列的WDF通道获得的白细胞计数似乎更准确。然后，我们针对此类罕见但关键的标本创建并引入了警报消息设置，当WNR通道和WDF通道之间的白细胞计数差异高于1.0×10⁹/L时，会发出警告。通过使用警报消息设置，我们能够从其他三例巨大血小板病例中检测到一些在常规WNR通道中白细胞计数出现假性升高的标本。总之，我们的警报消息设置似乎有助于避免因包括巨大血小板在内的异常细胞导致白细胞计数的错误报告。
