A number of hematologic changes may occur in patients with severe burns. These can result in false readings in some automated instruments.
Patient selection: thermal burn
Hematologic changes may include:
(1) schistocytosis
(2) spherocytosis and microspherocytosis
(3) Dohle bodies in neutrophils
(4) vacuolated monocytes
(5) erythrophagocytosis
Platelets performed by impedance or optical counting may interpret microspherocytes as platelets, causing a pseudo-thrombocytosis. These instruments will also undercount erythrocytes, resulting in a falsely high MCV and false low red blood cell count, while the hemoglobin will be closer to the true value.
A platelet count performed using automated fluorescent flow cytometry will report the correct platelet count.
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