Unclassified green dots on nucleated red blood cells (nRBC) plot in DxH900 from a patient with hyperviscosity syndrome
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Rafael José García Martínez
,
José Carlos Garrido Gomez
Abstract
Objectives
Analytical interferences, caused by antibodies, often go unnoticed and require a deep understanding of analyzer principles in the correct clinical context.
Methods
A case report details a 56-year-old man with symptoms of hyperviscosity syndrome (HVS) due to multiple myeloma.
Results
The DxH 900 analyzer revealed abnormalities in the nucleated red blood cell (nRBC) graph, attributed to a high concentration of IgA kappa. Immediate plasmapheresis successfully treated HVS, reducing the monoclonal component and eliminating the aberrant green signal.
Conclusions
In the appropriate clinical context, the recognition of analytical interferences is necessary for accurate clinical interpretation, and it is only possible with knowledge of the analytical principles of the instruments. In this case, the high concentration of IgA kappa generated an aberrant green signal in the VCSm.
Acknowledgments
We thank Maria Ángeles Martínez Martínez and Celia Gonzalez Samperio for their very helpful support.
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Research ethics: Not applicable.
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Informed consent: Not applicable.
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Author contributions: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.
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Competing interests: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
References
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