engleski

Noncognitive factors in preanalytics of CBC measurement: negligible impact or a disastrous mistake

Background: Complete blood count (CBC) is one of the most commonly ordered routine laboratory tests. Making great efforts to eliminate cognitive factors still can not affect those noncognitive ones, whose misinterpretation, if not recognized, may bring the patient into a considerable risk by diagnostic and therapeutic mistakes. Materials and methods: A total of four patients admitted to our Hospital were enrolled in this case reports. Blood samples were collected with dipotassium EDTA and with sodium citrate respectively. UniCell DxH 800, Beckman-Coulter hematology analyzer was used to perform CBC. Blood smears of samples were made for microscope observation (Olympus BX51). Samples with lipemia were centrifuged on Hettich Universal 320R for 5 min/20°C/4000 RPM. Samples with cold agglutination were heated in waterbath Rowa GmbH for 10 min/37°C. Results: In the first case it was a transient phenomenon-presence of cold agglutination of red blood cells due to a diagnosis of bilateral pneumonia with pleural effusion in the left chest, during antibiotic therapy. The second case discussed the transient EDTA-dependent pseudothrombocytopenia due to antibiotic treatment of erysipelas. The third case was an influence of lipemia on the value of hemoglobin and erythrocyte constants in the individual with previously known hyperlipemia. The fourth case described interference of malaria parasites on results of differential blood cell count. Conclusions: Misinterpreted results, due above described-noncognitive influences of errors, can give rise to erroneous diagnosis and inappropriate treatment. The present literature about influence of infectious diseases on preanalitical erors is scarce, so these errors should be recognized and described.

: preanalytical; lipemia; pseudothrombocytopenia; cold agglutination; malaria

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