Pseudoreticulocytosis in a patient with hemoglobin Köln due to autofluorescent erythrocytes enumerated as reticulocytes by the Cell-Dyn 4000

Laboratory Hematology : Official Publication of the International Society for Laboratory Hematology
Shoko SatoHaruhiko Ninomiya

Abstract

Pseudoreticulocytosis in a 25-year-old female patient with hemoglobin Köln is reported. The abnormal hemoglobin, hemoglobin Köln (beta chain, Val98-->Met), had previously been confirmed in the patient at the age of 21 years, as well as in her mother, by polymerase chain reaction-based direct sequence analysis of the beta globin gene. The patient underwent splenectomy at the age of 22 years. On her admission to our hospital for treatment of an immunoglobulin A nephropathy, an analysis by an automated hematology analyzer, the Abbott Cell-Dyn 4000 (CD4000), reported a marked reticulocytosis. Staining by the Brecher method with new methylene blue indicated a moderate reticulocytosis (5.7%) of a lesser extent than that indicated by the CD4000 (51.1%). The frequencies of red blood cells (RBC) with Pappenheimer bodies (13.8%), Heinz bodies (32.7%), and Howell-Jolly bodies (0.3%) were increased. The CD4000 detects RBC with RNA fluorescently stained with CD4K530 as reticulocytes. Autofluorescence of RBC with hemoglobin Köln, as we demonstrated by flow cytometry and fluorescent microscopy, was considered to have caused the pseudoreticulocytosis on the fully automated reticulocyte enumeration by the CD4000.

References

Sep 1, 1993·Annals of Hematology·B HertensteinH Heimpel
Dec 22, 1998·Acta Haematologica·G CarulliM Petrini
Feb 15, 2002·Clinical and Laboratory Haematology·C S ScottT L Coetzer

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Citations

Mar 26, 2005·Laboratory Hematology : Official Publication of the International Society for Laboratory Hematology·Neil HarrisAlexander Kratz
Jun 6, 2006·Laboratory Hematology : Official Publication of the International Society for Laboratory Hematology·Shoko SatoHaruhiko Ninomiya

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