We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Abbott Diagnostics- Hematology Division


Sysmex Europe designs and produces laboratory and hematology diagnostic solutions, including instruments, reagents, c... read more Featured Products: More products

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.
23 Sep 2021 - 25 Sep 2021

Fluorescent Lymphocytes and Smudge Cells Explored in Infectious Mononucleosis

By LabMedica International staff writers
Posted on 30 Aug 2021
Print article
Image: The Sysmex DI-60 is an automated, cell-locating image analysis system. It is connected directly to the analyzer track and therefore eliminates the need for manual intervention in the hematology workflow in the imaging cycle (Photo courtesy of Sysmex Corporation)
Image: The Sysmex DI-60 is an automated, cell-locating image analysis system. It is connected directly to the analyzer track and therefore eliminates the need for manual intervention in the hematology workflow in the imaging cycle (Photo courtesy of Sysmex Corporation)
Infectious mononucleosis (also known as Glandular fever) is an infection most commonly caused by the Epstein-Barr virus (EBV), which is a human herpes virus. Glandular fever is not particularly contagious. It is spread mainly through contact with saliva, such as through kissing, or sharing food and drink utensils.

The mono test is 71% to 90% accurate and may be used as an initial test for diagnosing infectious mononucleosis (IM). However, the test does have a 25% false-negative rate due to the fact that some people infected with EBV do not produce the heterophile antibodies that the mono test is designed to detect. Atypical lymphocytes appear, but the heterophilic agglutination test is negative.

Clinical Laboratorians at the Peking University Third Hospital (Beijing, China) enrolled in a study 62 IM patients, 67 healthy controls, 84 patients with upper respiratory tract virus infection, and 35 patients with malignant lymphoid diseases, to explore the diagnostic value of high fluorescent lymphocytes (HFLC) and smudge cells for infectious mononucleosis (IM). The complete blood counts and leukocyte differential counts were tested, and the smudge cells were manually counted.

Complete blood counts including red blood cells (RBC), hemoglobin (HGB), white blood cells (WBC), and leukocyte differential count, platelet (PLT), and HFLC percentage (HFLC%) were investigated with the Sysmex XN 9000 (Sysmex Corporation, Kobe, Japan). Manual leukocyte classification and smudge cells were counted by Sysmex DI-60. A total of 200 nucleated cells were read on each slide. The number of smudge cells seen per 100 nucleated cells was counted, and the blood smears were observed by two experienced technicians under an optical microscope.

The investigators reported that the value of HFLC% and smudge cells of the IM group were significantly higher than those of healthy controls and disease controls, and the HFLC% value of IM patients was positively correlated with the number of reactive lymphocytes. When the cutoff value of HFLC% was 0.4%, and of IM was high (AUC = 0.995). When the smudge cells >2/100 nucleated cells, the diagnostic value was further enhanced (AUC = 1.000). When the cutoff value of the HFLC% was 1.2%, it effectively distinguished IM patients from upper respiratory tract virus infection patients (AUC = 0.934). When smudge cells >16/100 nucleated cells, it also has high differential diagnosis value (AUC = 0.913). The combination HFLC% and smudge cells for the differential diagnosis can be increased to 0.968.

The authors concluded that HFLC% and smudge cells can be used as effective indicators in the early diagnosis and differential diagnosis of IM. HFLC% assists the diagnosis of IM with the following advantages: first, this indicator has high specificity and sensitivity for the diagnosis of IM, which can effectively avoid missed diagnosed; second, HFLC%, as one of the blood routine indicators, can be obtained directly from the automatic blood analyzer. The study was published on August 17, 2021 in the Journal of Clinical Laboratory Analysis.

Related Links:
Peking University Third Hospital
Sysmex Corporation

Gold Supplier
SARS-CoV-2 S-IgG Antibody Assay
Lumipulse G SARS-CoV-2 S-IgG
Gold Supplier
Molecular Diagnostic System
Singuway 9600 Pro
Methicillin-Resistant Staphylococcus Aureus RT PCR Test
VIASURE Methicillin-Resistant Staphylococcus Aureus Real Time PCR Detection Kit
Gold Supplier
SARS-COV-2 PLUS UK Real Time PCR kit

Print article



view channel
Image: The CellSearch Circulating Tumor Cell Kit is intended for the enumeration of circulating tumor cells of epithelial origin (CD45-, EpCAM+, and cytokeratins 8, 18+, and/or 19+ and PD-L1) in whole blood (Photo courtesy of CellSearch/Menarini Silicon Biosystems)

PD-L1 Expression in Circulating Tumor Cells Investigated for NSCLC

In non-small cell lung cancer (NSCLC), analysis of programmed cell death ligand 1 (PD-L1) expression in circulating tumor cells (CTCs) is a potential alternative to overcome the problems linked to the... Read more


view channel

Global Digital Polymerase Chain Reaction (dPCR) Market Projected to Reach Close to USD 1.15 Billion by 2028

The global digital polymerase chain reaction (dPCR) market is projected to grow at a CAGR of more than 9% from over USD 0.50 billion in 2020 to nearly USD 1.15 billion by 2028, driven primarily by rising... Read more
Copyright © 2000-2021 Globetech Media. All rights reserved.