The inflammation meter: novel technology to detect the presence of infection/inflammation in patients without leukocytosis but with increased leukocyte adhesiveness/aggregation.
OBJECTIVE
To reveal the presence of infection/inflammation in patients with relatively normal white blood cell count (WBCC) by using the leukocyte adhesiveness/aggregation test (LAAT).


METHODS
The LAAT was performed by using a simple slide test and image analysis (Inflamet), the WBCC, by an electronic cell analyzer, C-reactive protein, by Laser nephelometry and CD11b/CD18 by whole blood flow cytometry.


RESULTS
Forty out of a cohort of 121 patients with nonviral acute febrile illness had a WBCC within normal limits. The intensity of the inflammatory response in these individuals as judged by either C-reactive protein, or fibrinogen concentrations, erythrocyte sedimentation or polymorphonuclear leukocyte CD11b/CD18 expression was similar to that observed in patients with a leukocytic response. Our present finding that 63% out of the group with documented infection/inflammation and no leukocytosis had a significantly increased LAAT suggest that the lack of leukocytosis is in part a pseudoleukopenia, or is associated with some degree of uncompensated tissue leukostasis.


CONCLUSIONS
The lack of a leukocytic response in a patient with nonviral infection/inflammation is by no means a sign of a less inflammatory response. The increased state of leukocyte adhesiveness/aggregation might help to disclose the presence of inflammation in these individuals.
Maharshak
N
N
Department of Internal Medicine D, the Tel Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Kassirer
M
M
Zeltser
D
D
Rotstein
R
R
Rogowski
O
O
Shapira
I
I
Deutsch
V
V
Arber
N
N
Eldor
A
A
Berliner
S
S
D000328:Adult; D000368:Aged; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D018821:CD18 Antigens / Q000097:blood; D002448:Cell Adhesion; D002449:Cell Aggregation; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D005334:Fever / Q000097:blood / Q000209:etiology; D005340:Fibrinogen / Q000378:metabolism; D005434:Flow Cytometry; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods / Q000592:standards; D007239:Infections / Q000175:diagnosis / Q000473:pathology; D007249:Inflammation / Q000175:diagnosis* / Q000473:pathology; D007958:Leukocyte Count; D007962:Leukocytes / Q000166:cytology*; D007964:Leukocytosis / Q000473:pathology; D016177:Macrophage-1 Antigen / Q000097:blood; D008875:Middle Aged
D018821:CD18 Antigens; D016177:Macrophage-1 Antigen; D005340:Fibrinogen; D002097:C-Reactive Protein