Orphee mythic 22 - Page 47

REF : M22/UM/EN/014
3. INSTRUMENT SET UP
MYTHIC 22
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Parameter Specimen
Occurrence
Possible Indication of Error on MYTHIC 22
action
HGB
Leukocytosis
(+)
Cause:
high level of WBC causes excessive light
scatter that interferes with Hgb measurement.
Indication: very high WBC (>100,000/µL), ↑MCHC.
Centrifuge the sample
remove WBC and re-assay
the re-diluted RBC part. Or
use reference
spectrophotometric
method.
hyperlipidemia
(+)
Cause: in case of high level of lipids in blood will give
the plasma a “milky” appearance that causes
inaccurate Hgb measurement.
Indication: plasma appearance
↑
MCHC.
Use reference manual
methods and a plasma blank
to determine Hgb.
Abnormal Protein
hyperproteinemia,
hyperbilirubinemia
(+)
Cause: in case of high level (or abnormal) of
proteins in blood will give the lysed sample a
“cloudy” appearance that causes inaccurate Hgb
measurement.
Indication: lysed sample appearance ↑MCHC.
Use reference manual
methods and a plasma blank
to determine Hgb.
HCT Cold Agglutinin
(-)
Cause: high IgM level may lower RBC and increase
MCV.
Indication:
↑
MCV,
↓
HCT.
Seek for red cell clumping
on smear.
Leukocytosis
(+)
Elevation of WBC.
Abnormal Red Cell
Fragility
(-)
Cause : in case of chemotherapy cytotoxic and
immunosuppressive drugs may increase RBC as well
as WBC fragility leading to a low HCT.
Indication: P1 flag.
Spherocytosis (?)
Cause: in case of spherocytosis, sphered RBC are
smaller than normal RBC leading to a low HCT .
Indication:
↓
MCV, P2 &/or P3&/or R1 flags.
Seek for spherocytes on
smear.
MCV RBC agglutination (?)
Cause:
agglutinated RBC may cause an inaccurate
MCV value.
Indication : abnormal MCH and MCHC values.
Seek for clumped RBC on
smear.
Use reference manual
methods to determine the
accurate MCV value.
Megalocytic
Platelets
(-)
Cause: may cause a low inaccurate MCV value
because of an excessive size.
Indication: ↓Plt ↑MPV , P2 flag.
Seek for megalocytic
platelets on smear.
Leukocytosis (+)
Cause: high level of WBC interferes with MCV
determination.
Indication: very high WBC (>100,000/
µ
L) ,
↑
MCHC.
Use reference manual
methods to determine the
accurate MCV value.
(+): Instrument count is affected by an increase in the result.
(-): Instrument count is affected by a decrease in the result.
(?): Instrument count is affected by either an increase or decrease in the result which is sample dependent.