Objectives: Lipemia poses a significant preanalytical problem for complete blood count (CBC) measurement due to limited and non-standardized methods for recognition and removal. We aimed to verify the optical hemoglobin (Hb-O) measurements on the Sysmex XN-1000 hematology analyzer (HA) as a possible reliable method for managing lipemic CBC samples. Methods: Ninety CBC samples with varying Hb concentrations were gradually spiked with a lipid emulsion. Measurements were repeated and Hb-O concentrations were recorded. Spiked CBC samples were centrifuged (400 g/10 min). Plasma was carefully removed, and Hb concentration was measured. The values obtained from the lipemic samples were adjusted according to the measurements in the plasma. The removed plasma was substituted with the analyzer’s diluent, and measurements were repeated. Triglyceride concentrations were measured in lipemic plasma samples. Results: Hb-O showed statistically insignificant and acceptable bias compared to the initial Hb measurement according to the strictest acceptability criteria (−0.4 %, 95 % CI: −1.2–0.3, p=0.2447). The observed bias did not correlate with the degree of lipemia (rho=−0.072, 95 % CI: −0.295 to 0.157, p=0.537). Hemoglobin measured in samples with lipemic plasma replaced by analyzer diluent exhibited minimal, albeit statistically significant, bias (−1.1 %, 95 % CI: −2.0 to (−0.1), p=0.025). The observed bias negatively correlated with the degree of lipemia (rho=−0.369, 95 % CI: −0.550 to (−0.155), p=0.001). The highest unacceptable bias was found in the recalculated hemoglobin values based on the measured plasma hemoglobin (−3.5 %, 95 % CI: −4.1 to (−2.9), p<0.0001). Conclusions: Hb-O measurement is the most reliable measure of lipemia removal in CBC samples on the Sysmex XN-1000 HA.

The aims of study were to assess: 1) performance specifications of Atellica 1500, 2) comparability of Atellica 1500 and Iris, 3) the accuracy of both analysers in their ability to detect bacteria. Carryover, linearity, precision, reproducibility, and limit of blank (LoB) verification were evaluated for erythrocyte and leukocyte counts. ICSH 2014 protocol was used for estimation of carryover, CLSI EP15-A3 for precision, and CLSI EP17 for LoB verification. Comparison for quantitative parameters was evaluated by Bland-Altman plot and Passing-Bablok regression. Qualitative parameters were evaluated by Weighted kappa analysis. Sixty-five urine samples were randomly selected and sent for urine culture which was used as reference method to determine the accuracy of bacteria detection by analysers. Analytical specifications of Atellica 1500 were successfully verified. Total of 393 samples were used for qualitative comparison, while 269 for sediment urinalysis. Bland-Altman analysis showed statistically significant proportional bias for erythrocytes and leukocytes. Passing-Bablok analysis for leukocytes pointed to significant constant and minor proportional difference, while it was not performed for erythrocytes due to significant data deviation from linearity. Kappa analysis resulted in the strongest agreements for pH, ketones, glucose concentrations and leukocytes, while the poorest agreement for bacteria. The sensitivity and specificity of bacteria detection were: 91 (59-100)% and 76 (66-87)% for Atellica 1500 and 46 (17-77)% and 96 (87-100)% for Iris. There are large differences between Atellica 1500 and Iris analysers, due to which they are not comparable and can not be used interchangeably. While there was no difference in specificity of bacteria detection, Iris analyser had greater sensitivity.

Spheroplasts in a Croatian patient misclassified by two urine sediment analysers as erythrocytes: case report

Article Is successfulness of platelet clump disaggregation by vortexing influenced by platelet measurement methods? was published on July 31, 2025 in the journal Clinical Chemistry and Laboratory Medicine (CCLM) (volume 0, issue 0).

Resumen: Objetivos: La lipemia es un problema preanalítico reseñable para el proceso de recuento de células sanguíneas (CBC), ya que no existe un método estandarizado para su identificación y eliminación. El objetivo de presente estudio es verificar la medida de la hemoglobina óptica (Hb-O) en el hemoanalizador (HA) Sysmex XN-1000 como método fiable para el manejo del CBC en muestras lipémicas. Métodos: Empleando una emulsión de lípidos, se procedió a enriquecer gradualmente 90 muestras de CBC con concentraciones diferentes de Hb. Las determinaciones se repitieron y se registraron las concentraciones de Hb-O. Las muestras de CBC enriquecidas se centrifugaron (400 g/10 minutos). A continuación, se extrajo cuidadosamente el plasma y se midió la concentración de Hb. Los valores obtenidos de las muestras lipémicas se ajustaron de acuerdo a las determinaciones en plasma. El plasma eliminado se sustituyó con el diluyente del analizador, y se repitieron las mediciones. Se midieron las concentraciones de triglicéridos en el plasma de muestras lipémicas. Resultados: Se observó un sesgo estadísticamente no significativo y aceptable en la Hb-O con respecto a la determinación inicial de Hb, según los requisitos más estrictos de aceptabilidad (−0,4 %, IC95 %:−1,2–0,3, p=02,447). El sesgo observado no se correlacionó con el grado de lipemia (rho=−0,072, IC95 %:−0,295–0,157, p=0,537). La hemoglobina medida en muestras de plasma lipémico sustituidas por un diluyente del analizador mostró un sesgó mínimo, aunque estadísticamente significativo (−1,1 %, IC95 %:−2,0–(−0,1), p=0,025). El sesgo observado fue inversamente proporcional al grado de lipemia (rho=−0,369, CI 95 %:−0,550 – (−0,155), p=0,001). El mayor sesgo inaceptable se obtuvo al recalcular los valores de hemoglobina según la hemoglobina medida en plasma (−3,5 %, IC95 %: −4,1 – (−2,9), p<00,001). Conclusiones: La determinación de Hb-O es el método más fiable a la hora de eliminar la lipemia en muestras para recuento CBC en el hemoanalizador Sysmex XN-1000.