What is your diagnosis? Discrepancy between Sysmex XT-2000iV reticulocyte count and polychromasia

摘要

A 5-year-old Cocker Spaniel dog was reported to have anorexia, dyspnea, tachycardia (heart rate 200/min), icterus, polyuria, and vomiting. The referring veterinarian also reported severe anemia (hematocrit 18%) with autoagglutination and apparent hemoglobinuria and suspected immune-mediated hemolytic anemia. However, neither spherocytes nor autoagglutination was found on the blood smear. The erythrocytes appeared normal and lacked polychromasia (Figure 1). The blood was analyzed using the Sysmex XT-2000iV hemtology analyzer (Sysmex Corporation, Kobe, Japan) (Table 1). There was a large discrepancy between the automated reticulocyte count and lack of polychromasia on the blood smear.