title: Leukocyte aggregation-related pseudoleukopenia in pediatrics: a sporadic event or a systematic error?
abstract: 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.
authors.affiliation: Department of Pediatrics, Shaare Zedek Medical Center, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Urbach
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
authors.forename: David
authors.initials: D
authors.lastname: Branski
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.forename: Bernard
authors.initials: B
authors.lastname: Rudensky
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: Tamar
authors.initials: T
authors.lastname: Mardi
mesh_terms: 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