IN-VITRO LEUCOAGGLUTINATION: A STUDY OF 11 CASES

Objective: Cold agglutination of red blood cells and platelets are well recognized and extensively studied in literature. However aggregation of leukocytes in vitro is rare and may result in spuriously low leucocyte count. We present a case series of 11 patients with spurious leukopenia due to leucoagglutination in-vitro. Methods: A retrospective study was conducted at Clinical laboratory & Haematology division, Kasturba Hospital, compiling 11 cases which showed WBC clumping on the peripheral smear in the last 2 years. Results: The aetiologies ranged from immune mediated (4 cases), liver diseases (2 cases) and infections/drug induced (5 cases). The incubation of samples at 37° C for 30 minutes caused disaggregation of leucocytes; thus denoting the role of temperature dependent antibody. Conclusion: Leucoagglutination in-vitro can be linked to an immunological phenomenon, possibly due to a temperature-dependent antibody