A patient sample comes off an automated cell counter with a failure of the red cell "rule of three." The red count is lower than expected given the hemoglobin. The MCV, MCH, and MCHC are elevated. Which of the following is the most likely reason for this failure?

Question

Quizplus · Accepted Answer

Cold agglutinin can cause red blood cells to clump together, leading to an artificially low red cell count and falsely elevated MCV, MCH, and MCHC values, as the automated counters may interpret the clumps as single, large cells.

A Patient Sample Comes Off an Automated Cell Counter with a Failure