Pseudoleukocytosis secondary to hepatitis C-associated cryoglobulinemia: a case report.

Journal of Medical Case Reports
Abdallah GearaSuzanne El-Sayegh

Abstract

Laboratory tests play a central role in assessing a patient and orienting the diagnostic evaluation. We report a case where the discrepancy between the manual and automatic cell count gave a hint to the final diagnosis. A 55-year-old Caucasian man, known to have hepatitis C, was admitted with acute respiratory failure secondary to acute pulmonary edema and diffuse petechial rash of the lower extremities for the previous 2 months. The initial laboratory tests showed acute renal failure (creatinine of 2.6 mg/dL). During his hospital stay, the patient had a fluctuating white blood cell count with a recorded value of 96,000 cells/mL. On a peripheral smear, the blood cell count was in the normal range. The acute renal failure was secondary to membranoproliferative glomerulonephritis secondary to essential mixed cryoglobulinemia diagnosed by biopsy. The complete blood count values, performed by Beckman/Coulter GenS, were falsely high due to precipitation of plasma cryoglobulins at room temperature. This spurious leukocytosis was previously described in several case reports, but values as high as 96,000 cells/mL were never reported. The presence of cryoglobulins in the blood creates a clinical challenge for the interpretation of sever...Continue Reading

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Citations

Apr 15, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Xiang QianHong Wang

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Methods Mentioned

BETA
biopsy

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