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.

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