Superiority of a functional leukocyte adhesiveness/aggregation test over the white blood cell count to discriminate between mild and significant inflammatory response in patients with acute bacterial infections.
Electronic cell counters may underestimate the white blood cell count (WBCC) in the presence of aggregated leukocytes. In the present study we focused on the possibility of using a functional, as opposed to an anatomic, count to circumvent this eventual underestimation. A model of bacterial infection was used because of the importance of leukocytosis in the physician's clinical decision-making process. There were 35 patients with low C-reactive protein (CRP) concentrations (0.5-4.9 mg/dL), 45 with intermediate (5-9.9 mg/dL), and 120 with relatively high (>10 mg/dL) CRP concentrations. A significant (P=0.008) difference was noted between the state of leukocyte adhesiveness/aggregation in the peripheral blood of individuals with low CRP concentrations (3.5%+/-4.3%) and those with high CRP concentrations (7.4%+/-8%), while there was no significant difference in the respective number of WBCs per cubic millimeter (cmm) (11,600 +/- 5,500 and 14,000 +/- 7,200, respectively). We raise the possibility that a functional test might be superior over an anatomic count in patients with acute bacterial infection and a significant acute phase response.
Department of Internal Medicine "D", Tel Aviv Sourasky Medical Center/Sackler Faculty of Medicine, Tel Aviv, Israel.
Ori
O
Rogowski
Rivka
R
Rotstein
David
D
Zeltzer
Sarit
S
Misgav
Daniel
D
Justo
Daniel
D
Avitzour
Tamar
T
Mardi
Jacob
J
Serov
Nadir
N
Arber
Shlomo
S
Berliner
Itzhak
I
Shapira
D000268:Adhesiveness; D000368:Aged; D001424:Bacterial Infections / Q000097:blood* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D002449:Cell Aggregation; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007962:Leukocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
D002097:C-Reactive Protein