Four patients with abnormal hemoglobinemia found on the basis of extremely low side fluorescence light intensity on DIFF scattergrams obtained using multiparameter automatic hematology analyzer XE2100

Abstract

WBC-DIFF scattergrams obtained from newborn blood samples using an XE2100 multiparameter automatic hematology analyzer show low side fluorescence (SFL) intensities. We found six adult blood samples that exhibited significantly low SFL intensities. The affected and newborn blood cells were divided into red blood cells (RBCs), white blood cells (WBCs), and mixed with WBCs or RBCs separated from the blood of normal adults. Extremely low SFL intensities determined using XE2100 were observed for paired samples of newborn RBCs or affected RBCs mixed with normal WBCs. Our previous studies indicated that hemoglobinopathy showed abnormal WBC scattergrams obtained using an NE7000 multiparameter automatic hematology analyzer. Therefore, we speculated that extremely low SFL intensities obtained using XE2100 may have been due to some variations in RBCs or hemoglobinopathy; thus, we performed genetic sequencing analyses of globin genes from four of the six affected patients. Three patients showed HbJ-Calabria-type mutation and the other had Hb Yamagata-type mutation. It is of interest that hemoglobinopathy was found on the basis of DIFF scattergrams obtained using XE2100. However, the mechanism underlying the extremely low SFL intensities in hemoglobinopathy remains unclear.