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Maria Stella Graziani

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Martina Zaninotto

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Ferruccio Ceriotti
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Giuseppe Agosta

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da L. D'Amore

Informazioni inaspettate dall’esame emocromocitometrico: variante emoglobinica Hb Leiden rilevata tramite un analizzatore ematologico
Unexpected information from a blood count test: a hemoglobin variant, Hb Leiden, detected with a hematology analyzer
<p>Hemoglobin variants are abnormal forms of hemoglobin that may cause hematological disorders. The variants can be (or not) associated with normal hematology parameters. We were able to identify a hemoglobin variant in a 56-year-old Italian Caucasian male using a hematology analyzer.<br />A routine complete blood count was performed on the Sysmex XN-9000 analyzer for a patient presenting at the Emergency Department with dizziness. Unusual morphological alarms were reported by the analyzer. The microscopy observation of the peripheral blood smear showed a significant number of contracted ed cells and target red cells. Differential count cytograms showed changes in the distribution of the cell clusters and a reduction in the fluorescence signal. In the hypothesis that these alterations were caused by a hemoglobin variant, a HPLC test was performed and a variant in the D/E zone was detected. Molecular analysis confirmed the presence of a variant identified as Hb Leiden. We were thus able to demonstrate the importance to correlate instrumental alarms with validation rules to detect variants in cases where clinical evidence was lacking. The introduction of a new validation rule that automatically activates reticulocyte count and peripheral blood smear in case of specific instrumental alarms is highly advisable.</p>
Biochimica Clinica ; 45(3) e023-e026
Casi clinici - Case report