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Peer-reviewed veterinary case report

False high white blood cell counts in cats with Heinz body anemia

By Johnson, Courtney E et al.·Published in Veterinary clinical pathology·2020·Department of Veterinary Clinical Sciences, United States·View original on PubMed

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Original publication title: Spurious, marked leukocytosis in 2 cats with Heinz body hemolytic anemia.

Species:
cat

Plain-English summary

Two domestic shorthair cats were brought to the vet because they were not eating and were dehydrated after eating caramelized onions. Blood tests showed some unusual results, including a false high white blood cell count and signs of anemia due to Heinz body hemolytic anemia, which is caused by the breakdown of red blood cells. The vets confirmed these findings by re-testing the blood samples and found that the initial results were misleading. Both cats received supportive care, and with proper treatment, they were able to recover from their symptoms.

People also search for: cat not eating after onions · Heinz body anemia in cats · cat dehydration treatment

Abstract

Two domestic shorthair cats were presented with anorexia and dehydration following ingestion of caramelized onions. Shared key findings from a CBC (ADVIA 2120), serum biochemistry, and urinalysis included a spurious, marked leukocytosis with discordant basophil (BASO) channel and peroxidase channel WBC counts, normal manual leukocyte counts, mild, non-regenerative anemia with discrepancies between automated and manual reticulocyte counts, an abundance of large Heinz bodies (HBs), and highly irregular scattergrams. Case 1 also demonstrated a markedly elevated mean corpuscular hemoglobin concentration (MCHC) and discrepancies between RBC hemoglobin indices. Spurious leukocyte results were confirmed through re-analysis of samples (including the acquisition of a new sample, use of an alternate analyzer (Sysmex XT-2000iV; Case 1 only), and evaluation of scattergrams and blood films (Cases 1 and 2). Repeatedly discrepant reticulocyte counts were also identified. In both cases, the erroneous BASO WBC counts, discrepancies in reticulocyte counts and RBC indices, and atypical scattergrams were interpreted to result from various effects of the HBs. These cases emphasize the importance of reviewing blood films, interpreting scattergrams, and the usefulness of duplicate methods for determining various measurands on hematology analyzers.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32458505/