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Mononucleosis: Peculiarity of Blood Count Scattergram Performed on Abbott Alinity Hq
International Journal of Laboratory Hematology ; 45(Supplement 1):75, 2023.
Article in English | EMBASE | ID: covidwho-2218699
ABSTRACT

Introduction:

Mononucleosis is an infectious disease caused by Epstein-Barr virus (EBV, human herpes virus type 4, HHV-4) and is characterized by asthenia, fever pharyngitis, and lymphadenopathy. In our laboratory diagnosis is made by rapid test and Epstein-Barr virus antibody assay. The presence of Epstein-Barr virus (VCA) specific IgM antibodies indicates primary infection. A marked lymphocytosis with inversion of the formula can be seen on the blood count. The smear shows numerous activated lymphocytic elements By examining the complete scattergram of patients with confirmed primary infection we noticed a peculiar arch arrangement of the lymphocytes in the FL1 x ALL specific leukocyte scatters. Method(s) In this study Vircell's Virapid mono M&G is used, an immunotest for the qualitative determination of 4 serological markers of EBV two IgM, VCA and heterophile, and two IgG, VCA and EBNA. The presence of anti-VCA IgM antibodies and the absence of anti-EBNA antibodies are indicative of primary infection. CBC was performed on Abbott Alinity hq, which uses a combination of photometry optical counting and fluorescence analysis in order to enumerate cells and cellular constituens. The instrument utilizes eight light scatter detectors which include ALL (axial light loss), IAS (intermediate angles of light scatter), PSS (polarized side scatter), DSS (depolarized side scatter) and FL1 ( fluorescent channel). Result(s) The sixteen cases examined, all of which resulted positive for primary infection on the rapid test, showed a peculiar FL1 x ALL scattergram (see Fig.1). In the lymphocytes' scattergram cloud, we observed an archshaped trend going upwards and rightwards, thus highlighting cells with greater fluorescence and size Often these lymphocytes are identified as monocytes In cases of lymphocytosis from other causes (CLL lymphomas) we can see how the lymphocytes' scattergram cloud is totally different. In such a case the cloud seems like a short bar due to lymphocytes with increased fluorescence signal though with small size (see Fig.2). Conclusion(s) In the 16 cases of primary EBV infection examined, the blood count shows a peculiar FL1 x ALL scattergram, which compared with the scattergram of other causes of lymphocytosis highlights a substantial difference that could support the laboratory technician in the diagnostic differentiation of a lymphocytosis lymphocytic response to viral infection (EBV, SARS-Cov19, ecc) or monoclonal lymphocyte proliferation.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: International Journal of Laboratory Hematology Year: 2023 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: International Journal of Laboratory Hematology Year: 2023 Document Type: Article