sysmex and specimens with cold antibodies and icteric interference

[tkakin]

We have a patient with a very strong cold antibody who also has icteric interference.  In order to resolve the high MCHC we have to do a warm saline replacement, this works splendidly. 

My question is in regards to the retic.  When we run the retic without doing a warm saline replacement vs with the warm saline replacement there is a significant difference in results. 

Are we supposed to do the warm saline replacement to get a valid retic count or is it unnecessary?

Thank you very much

[kimannez]

Hi! In the absence of a "RET Abn Scattergram" flag or a RBC Count action message, the retic count from the sample with the replaced plasma should be the most accurate result. The agglutinated RBCs falsely lower the RBC count which would affect the absolute retic count, also. You could also verify the retic count manually to determine the best results.