title: Two cases of false platelet clumps flagged by the automated hematology analyzer Sysmex XE-2100.
abstract: BACKGROUND
  Automated hematology analyzer is widely used by clinical laboratories to examine blood cell counts and differential leukocyte counts. However, a microscopic examination of a well-prepared blood film is still necessary and useful in most cases.
  
  
  METHODS
  Two patients with severe disease were required complete blood counts (CBC) after admission at West China Second University Hospital in Southwest China.
  
  
  RESULTS
  A false "platelet clumps?" flag was generated by the automated hematology analyzer Sysmex XE-2100. However, when the well-prepared blood film was reviewed, there was echinocytosis rather than clumps of platelets. In addition, both patients had severe metabolic acidosis with arterial blood pH <7.00 and HCO3- <4 mmol/l. On day 2 of admission, the false platelet clumps flags were not presented in both cases.
  
  
  CONCLUSIONS
  Our further results suggested that the false platelet clumps had been flagged probably due to the influence of the extremely low blood pH. These two cases emphasized that a microscopic examination of a blood film was central to the morphology of blood cells. When the result of microscopic examination was abnormal, it was suggested that the physician should consider further testing to find underlying condition.
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Qingkai
authors.initials: Q
authors.lastname: Dai
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Chunqi
authors.initials: C
authors.lastname: Lai
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Zeli
authors.initials: Z
authors.lastname: Du
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Leiwen
authors.initials: L
authors.lastname: Peng
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Yuefang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ye
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
authors.forename: Xianjun
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China. Electronic address: jiangyongmei-1@163.com.
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D001331:Automation; D002648:Child; D003920:Diabetes Mellitus / Q000097:blood; D005189:False Positive Reactions; D006403:Hematologic Tests; D006801:Humans; D007223:Infant; D008297:Male; D010974:Platelet Aggregation; D047928:Premature Birth / Q000097:blood
keywords: Complete blood count; Echinocyte; Erythrocyte morphology; Hematology analyzer; Platelet