UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 17 / No. 2 / Published : 2010-11

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Original Article :

Star ()-flagged leukocytosis as indicator of interfering factor in automatic hematology analyzer

Author :

  1. Christine Sugiarto*1
  2. Leni Lismayanti*2
  3. Nadjwa Zamalek Dalimoenthe*3
  1. Bagian Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran/RS. dr. Hasan Sadikin, Bandung
  2. Bagian Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran/RS. dr. Hasan Sadikin, Bandung
  3. Bagian Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran/RS. dr. Hasan Sadikin, Bandung

Abstract :

Leukocytosis is a condition in which there is an increasing number of white blood cell count in the peripheral blood compared to the normal range based on age. Several conditions can amplify leukocyte count from haematological auto analyzers, not only those which correspond to the pathologic and physiologic condition, but also with other factors, such as diluent and haematological auto analyzer’s methods. The information about these factors should be evaluated to lessen errors in the patient’s diagnosis and therapy. This case report describes a leukocytosis in a 35-day old baby boy, diagnosed as duodenal obstruction, admitted in Paediatric Surgery Department, Hasan Sadikin Hospital, Bandung. Discrepancies occurred in this patient’s leukocyte count with some different haematological auto analyzers. The leukocyte count from the auto analyzer by impedance method and ammonium salt diluent was 129.200/mm3 which was indicated by a star-flagged (), while from the auto analyzer with light scatter method and anhydrous sodium sulphate and sodium chloride diluent was 9.200/mm3, from manual count by the counting chamber with Turk diluent was 14.200/mm3 and the estimation by peripheral blood smear was 7.000–10.000/mm3. False leukocytosis by auto analyzer with impedance method was caused by the limitation of the analyzer’s method and by the erythrocyte lysine reagent (diluent) using ammonium salt. As investigated in this case, the interferences were thought as being caused by the Lyses-resistant Red Blood Cells, thus the non-lysed/lyses cells which were enlarged in size were identified as leukocytes other than erythrocytes. It can be that the white blood concluded cell count examination which is indicated by star-flagged (), or white blood cell count >100.000/mm3 must be confirmed by manual examination (counting chamber and peripheral blood smear) or by another haematological auto analyzer method that has a different and more potent diluent.

Keyword :

Leukocytosis with star-flagged (), interfering factor, hematology analizer,


References :

Cielsa BE, Simpson P,(1997) Evaluation of Cell Morphology and Introduction to Platelet and White Cell Morphology Washington DC : FA. Davis Company





Archive Article

Cover Media Content

Volume : 17 / No. : 2 / Pub. : 2010-11
  1. The Diagnostic Value Of Heart-type Fatty Acid Binding Protein (h-fabp) Rapid Test Related To Cardiac Troponin I In Non St Elevation Myocardial Infarction (nstemi)
  2. The Creatinine Level And Potassium Serum In Patients With And Without Type Ii Diabetic
  3. Procalcitonin For The Differentiation Of Bacterial And Non Bacterial Infection
  4. Diagnosis Of Dengue Virus Infection With Iga Anti Dengue Rapid Tests
  5. The Platelet Aggregation Test As A Predictor Of Clinical Outcome In Acute Infarction Stroke
  6. Association Between Atypical Depolarization On The Cell-dyn 3200 And The Presence Of Plasmodium Spp In Blood In The Dr. Soetomo Hospital Surabaya
  7. The Correlation Between Thrombocyte And Cd4 Count In Hiv/aids Patients
  8. The Chemotherapy Effect In The Activity Of Transaminase Enzymes In Breast Cancer Patients
  9. Pathogenesis And Laboratory Examination Of Primary Myelofibrosis
  10. Star ()-flagged Leukocytosis As Indicator Of Interfering Factor In Automatic Hematology Analyzer
  11. (oral Administration Of Mycobacterium Tuberculosis 38-kilodalton Adhesin Protein Increases Macrophages And Lymphocytes In Intestinal Balb/c Mice)
  12. Diazo Test As A Screening Test Of Typhoid Fever A Practical Approach

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