Hematology Case Study - IG Present #2

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This patient presented with leukocytosis, neutrophilia and basophilia. Immature Granulocytes (IG) are present in the automated differential, although slightly lower counts are reported using manual microscopy. Studies have shown that the manual differential, while long considered a reference method, is subject to variation resulting from experience of the technologist, area of the smear evaluated and smear/stain quality. Sysmex analyzers use fluorescent flow cytometry to provide an immature granulocyte result which includes metamyelocytes, myelocytes and promyelocytes. The “IG Present” message is generated based on a user defined IG # and/or % threshold. In this case, the “Left Shift?” flag suggests there may also be bands present.

NRBCs are detected by the XN analyzer but not on the manual differential; this is due to the XN’s ability to count more cells with higher precision than the 100-cell manual differential.

The clinical applications or uses presented in these materials, including case studies, are provided for illustration purposes only. Prior to using any Sysmex device, please review the manufacturer’s instructions use. It is the healthcare provider’s responsibility to determine applicability in routine clinical practice.

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