Deviation from Normal Values of Leukocyte and Erythroblast Parameters in Complete Blood Count is a Messenger for Platelet Abnormalities

Automated blood cell counters have undergone a formidable technological evolution owing to the introduction of new physical principles for cellular analysis and the progressive evolution of software [1,2]. The results have been an improvement in analytical efficiency and an increase in information provided with new parameters. A 61-year-old male patient had the diagnosis of diffuse large B-cell lymphoma 6 years ago, and after chemotherapy, he was still in remission. He was hospitalized for high fever, fatigue, acute renal failure, and bibasilar crepitant rales. Complete blood count measured with a Beckman Coulter LH 780 hematology analyzer revealed an uncorrected leukocyte count (UWBC) of 63.5x109/L, leukocyte count (WBC) of 22.1x109/L, erythroblast count (NRBC) of 21.4x109/L, and platelet count of 197x109/L (Figure 1). Upon peripheral blood smear examination, we detected 5% neutrophils, 22% band forms, 61% metamyelocytes, 5% myelocytes, 1% promyelocytes, 2% myeloblasts, 2% lymphocytes, and 2% eosinophils. We also detected rare erythroblasts and large platelets with profuse platelet clumps (Figures 2 ). Routine biochemical analysis revealed high fasting glucose, blood urea nitrogen, creatinine, serum glutamic oxaloacetic transaminase, alkaline phosphatase, direct and indirect bilirubin, albumin, and lactate dehydrogenase. The erythrocyte sedimentation rate was 100 mm/h, and serum ferritin was 2944 ng/mL. High-resolution computed tomography of the thorax revealed bilateral diffuse infiltrations, nodular opacities, right pleural effusion, and mediastinal lymphadenopathies. Clarithromycin and imipenem/cilastatin were administered Deviation from Normal Values of Leukocyte and Erythroblast Parameters in Complete Blood Count is a Messenger for Platelet Abnormalities Tam Kan Sayımında Lökosit ve Eritroblast Parametrelerinin Normal Değerlerden Sapması Trombosit Anormallikleri için bir Habercidir