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1、令人吃惊的血常规检查结果之血小板篇INTERNATIONALJOURNALOFLABORATORYHEMATOLOGYSpuriouscountsandspuriousresultsonhaematologyanalysers:areview.Parti:plateletsM.ZANDECKI,F.GENEVIEVE,J.GERARD,A.GODONHaematologyLaboratory,UniversityHospitalofAngers,Angers,FraneeCorrespondenee:M.Zandecki,HaematologyLa
2、borat・ory,UniversityHospitalofAngers,4rueLarrey,49000Angers,France・Tel.:+33241355353;Fax:+33241355599;E・maikmazandecki@chu・angers.frdoi:10.1111/j.1365-2257.2006.00870.xSUMMARYReceived30January2006;acceptedforpublication30July2006Keywordshaematologyanalysers,automatedcount,cell
3、bloodcount,spuriouscount,plateletsThewidespreaduseofhaematologyanalysers(HA)hasledtoamajorimprovementofcellularhaematology’becauseofquickandaccurateresultsfoundinmostinstances.However,inseveralsituations,spuriousresultsareobserved」nadequatebloodsamples,situationsinducedbythean
4、ticoagulant(s)used,peculiarchangesrelatedtothepathologyinthepatient’andtechnicalconsiderationsaboutperformancesofthevariousHAmustbeconsidered.Spuriousthrombocytopeniaoccursinseveralcircumstancesrelatedtothepresenceofethylenediaminetetra・aceticacid(EDTA)usedastheanticoagulant.M
5、echanismofEDTA-dependentplatelet(PLT)agglutinationisrelatedtocirculating(auto)antibodiesdirectedagainstnormallyhiddenepitope(s)intheglycoproteinalphallb/betaHlacomplexfromPLTmembraneexposedonlyinthepresenceofEDTA.OtherspuriouslylowPLTcountsmayberelatedtoEDTAJncludingPLTrosetti
6、ngaroundwhitebloodcells(WBC;satellitism)andPLT-WBCaggregates,butmechanismsresponsibleforthoselatterphenomenaarelesswellknown.SpuriousincreaseofPLTcountmayberelatedtoseveralsituations,includingfragmentedredbloodcells,cytoplasmicfragmentsofnucleatedcells,cryoglobulins’bacteriaor
7、fungi,andlipids.Flagsgeneratedinseveralofthesesituationsalerttheoperatoronpossibleabnormal?ndingsandmayidentifytheproblem.AnalysingonlyPLTparametersisnotsuf?cient:inmanysituationstheWBCdifferentialscattergramisofcrucialhelpfor?agging.Flagsgenerateddependonthesoftwareversionont
8、heHAused,theperformanceindetectingthesameanomaliesmaydifferac
