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Cryoglobulinemia concurrent with Leishmania infantum infection in a dog and its interference with two automated hematology analyzers.

Vet Clin Pathol

December 2024

Servei d'Hematologia Clínica Veterinària, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain.

Article Synopsis
  • * The blood tests showed issues like marked thrombocytosis and unexpected findings of cryoglobulins, leading to complex hematological results that were partially resolved by warming the blood sample.
  • * Additional testing revealed the dog had a Leishmania infantum infection, marked hyperproteinemia, and mild splenomegaly, highlighting the unique presentation of monoclonal hypergammaglobulinemia and cryoglobulinemia in a dog with this infection.
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Introduction: Laboratory tests play a central role in assessing a patient and orienting the diagnostic evaluation. We report a case where the discrepancy between the manual and automatic cell count gave a hint to the final diagnosis.

Case Presentation: A 55-year-old Caucasian man, known to have hepatitis C, was admitted with acute respiratory failure secondary to acute pulmonary edema and diffuse petechial rash of the lower extremities for the previous 2 months.

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Four cases showing different means to detect cryoglobulins are reported: effects on blood cell counts performed on 2 technologically different automated hematology instruments and microscopic features in fresh blood samples and on May-Grünwald-Giemsa-stained bloodfilms. These cases were chosen for their instructive value in depicting all artifacts associated with cryoglobulins. Laboratory recognition of the cryoglobulins is important to correct factitious results with automated blood cell counters, mainly pseudoleukocytosis and pseudothrombocytosis.

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