Spurious Low WBC Count from Sysmex XN3000: a Case Report

BACKGROUND: We present a case of spurious low WBC count in a liver transplant patient. The patient is a 56-year-old man with liver cancer. METHODS: His routine blood test revealed a decrease in WBC count: 0.03 x 109/L compared to 19.30 x 109/L before. The WBCs in the blood smear appeared higher than that reported by the XN without any aggregation. We diluted the blood sample to 1:7 with the DCL of the XN. RESULTS: The diluted result matches the blood smear. CONCLUSIONS: Dilution mode may be a good choice when there is WNR and WDF discordance, and a smear must be reviewed.