A critical review on the assurance of accuracy in automated complete blood count test reports by rectification of spuriously elevated MCHC values

Authors

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251670

Keywords:

Automated complete blood count, Report accuracy, Spuriously elevated MCHC

Abstract

Spuriously elevated or decreased results are encountered frequently in hematology analysers in various parameters of the complete blood count (CBC). These results can be either true reflections of patient’s disease or may be spurious findings due to multiple pre- analytical factors. It is necessary to review these spurious results and perform necessary corrective actions before issuing the final report to the patient. Correction of spurious results ensures accuracy of the patient results and thereby helps the clinicians in providing optimal diagnosis and treatment to the patients. In this study, the predominant focus is on mean corpuscular haemoglobin concentration (MCHC) elevation which is derived as a calculation from haemoglobin and haematocrit values. As a result, it can be affected by preanalytical, postanalytical or analytical factors. In literature there are only a few articles related to correction of spuriously high MCHC. This article reviews most important studies available in literature on correction of spuriously high MCHC.

Metrics

Metrics Loading ...

References

El Brihi J, Pathak S. Normal and Abnormal Complete Blood Count with Differential. Treasure Island: StatPearls Publishing; 2024.

Sheudeen AA, Anthony AU, Muritado MA, Madu A, Ademola L, Adepoju OC, et al. Erythrocyte indices variations in under five children as a result of high plasmodium Falciparum parasitaemia. J Appl Health Sci Med. 2023;3(11):1-20. DOI: https://doi.org/10.58614/jahsm3111

Dondelinger RM. Hematology analyzers. Biomed Instrum Technol. 2009;43(4):300-4. DOI: https://doi.org/10.2345/0899-8205-43.4.300

Åsberg AE, Mikkelsen G, Aune MW, Åsberg A. Empty iron stores in children and young adults--the diagnostic accuracy of MCV, MCH, and MCHC. Int J Lab Hematol. 2014;36(1):98-104. DOI: https://doi.org/10.1111/ijlh.12132

Cornbleet J. Spurious results from automated hematology cell counters. Laboratory Medicine. 1983;14(8):509-14. DOI: https://doi.org/10.1093/labmed/14.8.509

Dacie JV. Dacie and Lewis practical haematology. Elsevier Health Sciences. 2006.

Gulati G, Uppal G, Gong J. Unreliable automated complete blood count results: causes, recognition, and resolution. Ann Lab Med. 2022;42(5):515-30. DOI: https://doi.org/10.3343/alm.2022.42.5.515

Li G, Lu M, Wang Q, Lu T. Two cases of false elevation of MCHC. Clin Lab. 2024;70(7):556. DOI: https://doi.org/10.7754/Clin.Lab.2024.240212

Cook S. Increased mean cell haemoglobin concentration. Clin Chem. 2022;68(6):861-2. DOI: https://doi.org/10.1093/clinchem/hvab253

Zandecki M, Genevieve F, Gerard J, Godon A. Spurious counts and spurious results on haematology analysers: a review. Part I: platelets. Int J Lab Hematol. 2007;29(1):4-20. DOI: https://doi.org/10.1111/j.1365-2257.2006.00870.x

Godon A, Genevieve F, Marteau-Tessier A, Zandecki M. Automated hematology analysers and spurious counts Part 3. Haemoglobin, red blood cells, cell count and indices, reticulocytes. Ann Biol Clin. 2012;70:155–68. DOI: https://doi.org/10.1684/abc.2012.0685

Eberle SE, Sciuccati G, Bonduel M, Díaz L, Staciuk R, Torres AF. Indices eritrocitarios en la esferocitosis hereditaria (Erythrocyte indexes in hereditary spherocytosis). Medicina (B Aires). 2007;67(2):698-700.

Risinger M, Glogowska E, Chonat S, Zhang K, Dagaonkar N, Joiner CH, et al. Hereditary xerocytosis: Diagnostic considerations. Am J Hematol. 2018;93(3):67-9. DOI: https://doi.org/10.1002/ajh.24996

Arays R, Shmookler AD. Educational Case: Warm Autoimmune Hemolytic Anemia. Acad Pathol. 2020;7:2374289520968228. DOI: https://doi.org/10.1177/2374289520968228

Jäger U, Barcellini W, Broome CM, Gertz MA, Hill A. Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting. Blood Rev. 2020;41:100648. DOI: https://doi.org/10.1016/j.blre.2019.100648

Berentsen S, Tjønnfjord GE. Diagnosis and treatment of cold agglutinin mediated autoimmune hemolytic anemia. Blood Rev. 2012;26:107–15. DOI: https://doi.org/10.1016/j.blre.2012.01.002

Swiecicki PL, Hegerova LT, Gertz MA. Cold agglutinin disease. Blood. 2013;122(7):1114-21. DOI: https://doi.org/10.1182/blood-2013-02-474437

Topic A, Milevoj KL, Bronic A, Pavic M. Effect of cold agglutinins on red blood cell parameters in a trauma patient: a case report. Biochem Med (Zagreb). 2018;28(3):31001. DOI: https://doi.org/10.11613/BM.2018.031001

Fernández PC, Castro CMJ, Sánchez NL, Rapún ML, Morales IC, Arrobas VT. Handling of lipemic samples in the clinical laboratory. Adv Lab Med. 2023;4(1):5-27. DOI: https://doi.org/10.1515/almed-2023-0003

Savage RA. CAP Today, July 2004. College of American Pathologists. Available at: http://www.captoday. Accessed on 25th January 25, 2016.

De Jonge G, Dos Santos TL, Cruz BR, Simionatto M, Bittencourt JIM, Krum EA, et al. Interference of in vitro hemolysis complete blood count. J Clin Lab Anal. 2018;32(5):22396. DOI: https://doi.org/10.1002/jcla.22396

Doig K, Zhang B. A methodical approach to interpreting the red blood cell parameters of the complete blood count. American Soci Clin Laborat Sci. 2017;30(3):173-85. DOI: https://doi.org/10.29074/ascls.30.3.173

Marques-Garcia F. Methods for hemolysis interference study in laboratory medicine-a critical review. EJIFCC. 2020;31(1):85-97.

Kroll MH, Elin RJ. Interference with clinical laboratory analyses. Clin Chem. 1994;40(11):1996-2005. DOI: https://doi.org/10.1093/clinchem/40.11.1996

Henry S, Gérard D, Salignac S, Perrin J. Optimizing the management of analytical interferences affecting red blood cells on XN-10 (Sysmex®). Int J Lab Hematol. 2022;44(6):1068-77. DOI: https://doi.org/10.1111/ijlh.13951

Simundic AM, Nikolac N, Ivankovic V, Ferenec-Ruzic D, Magdic B, Kvaternik M, et al. Comparison of visual vs. automated detection of lipemic, icteric and hemolyzed specimens: can we rely on a human eye? Clin Chem Lab Med. 2009;47(11):1361-5. DOI: https://doi.org/10.1515/CCLM.2009.306

Bashir BA. Spurious Augmentation of Mean Corpuscular Hemoglobin Concentration: Facts and Denotations. Clin Res Hematol 2020;3(2):1-3. DOI: https://doi.org/10.33309/2639-8354.030202

Downloads

Published

2025-05-30

How to Cite

Saidarakath, J., Bery, K., Ahmed, I. A. E., & Ambra, H. (2025). A critical review on the assurance of accuracy in automated complete blood count test reports by rectification of spuriously elevated MCHC values. International Journal of Research in Medical Sciences, 13(6), 2680–2684. https://doi.org/10.18203/2320-6012.ijrms20251670

Issue

Section

Review Articles