Leukocyte aggregation-related pseudoleukopenia in pediatrics: a sporadic event or a systematic error?
OBJECTIVE
To determine whether electronic counter-related pseudoleukopenia is a rare phenomenon or a systematic underestimation in children with acute infection/inflammation.


METHODS
We have used a simple slide test and image analysis to reveal the number of white blood cells and their degree of aggregation. The number of leukocytes counted by an electronic cell analyzer was divided by the number of cells counted on the slides creating an electronic cell-to-slide leukocyte count ratio.


RESULTS
A significant (P < 0.0005) negative (r = -0.314) correlation between the above mentioned ratios and the percent of aggregated leukocytes in the peripheral blood was found in a group of 239 children with various acute infections. Thus elevated leukocyte aggregation is associated with a relatively lower electronic analyzer cell count.


CONCLUSIONS
The appearance of aggregated leukocytes in the peripheral blood during acute infections might be associated with pseudoleukopenia. This phenomenon has been extensively described in the adult population and seems to exist in children as well.
Urbach
Joseph
J
Department of Pediatrics, Shaare Zedek Medical Center, Israel.
Rogowski
Ori
O
Branski
David
D
Shapira
Itzhak
I
Rudensky
Bernard
B
Berliner
Shlomo
S
Mardi
Tamar
T
D001424:Bacterial Infections / Q000097:blood; D002448:Cell Adhesion; D002449:Cell Aggregation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007249:Inflammation / Q000097:blood; D007958:Leukocyte Count / Q000706:statistics & numerical data*; D007962:Leukocytes / Q000502:physiology*; D007970:Leukopenia / Q000175:diagnosis*; D008297:Male; D014777:Virus Diseases / Q000097:blood