Anticoagulant induced leukoagglutination

Low leukocyte count secondary to leukocyte aggregation caused by an ethylene diamine tetra acetic acid (EDTA) occur in both benign and malignant disorders. We report a 71-year-old male patient who was admitted to the hospital with acute chest infection. Complete blood count (CBC) collected in EDTA tube and analyzed by sysmex instrument SE/9500 revealed low hemoglobin level of 9.4g/dl, white blood cell (WBC) count of 8.2x109/L and neutrophils of 4.8x109/L. Peripheral blood smear review shows multiple leukocytes aggregation one clump in each field. When we ask for another blood sample in citrate anticoagulant, the CBC showed WBC count of 11.8x109/L and neutrophils of 6.26 x 109/L. This is a case of low leukocyte count secondary to leukocyte aggregation induced by EDTA