Stress in the emergency room: a simple leukocyte to glass adhesion test provides a diagnostic tool to differentiate between stress and infection/inflammation related leukocytosis

Abstract

In order to discriminate between stress‐induced leukocytosis and an infection/inflammation‐related one, we have used a modified leukocyte adhesiveness/aggregation test (LAAT) to examine the adhesive properties of white blood cells towards glass surfaces. A highly significant p<0·00001) difference was noted between the percent of aggregated cells found in a group of patients with various conditions of infection/inflammation (22·9±6·4%) and those with stress (7·5±1·4%). The corresponding difference between the total white blood cell count in the peripheral blood of these two groups (16,547±3289 and 14,114±4898 cells per mm3, respectively) was not significant. The difference in total leukocytes adhered to the glass in the two groups (445±136 vs 228±72 cells per high power field) that were determined along the slide was also highly significant (p<0·00001). Thus, a simple glass slide technique might be of clinical utility for an effective, rapid and inexpensive means of discrimination between stress and infection/inflammation related leukocytosis. Copyright © 1999 John Wiley & Sons, Ltd.