The Inflammation Meter: Novel Technology to Detect the Presence of Infection/Inflammation in Patients without Leukocytosis but with Increased Leukocyte Adhesiveness/Aggregation

Abstract

Objectives: To reveal the presence of infection/inflammation in patients with relatively normal white blood cell count (WBCC) by using the leukocyte adhesiveness/aggregation test (LAAT). Methods: The LAAT was performed by using a simple slide test and image analysis (Inflamet™), the WBCC, by an electronic cell analyzer, C-reactive protein, by Laser nephelometry and CD11b/CD18 by whole blood flow cytometry. Results: Forty out of a cohort of 121 patients with nonviral acute febrile illness had a WBCC within normal limits. The intensity of the inflammatory response in these individuals as judged by either C-reactive protein, or fibrinogen concentrations, erythrocyte sedimentation or polymorphonuclear leukocyte CD11b/CD18 expression was similar to that observed in patients with a leukocytic response. Our present finding that 63% out of the group with documented infection/inflammation and no leukocytosis had a significantly increased LAAT suggest that the lack of leukocytosis is in part a pseudoleukopenia, or is associated with some degree of uncompensated tissue leukostasis. Conclusions: The lack of a leukocytic response in a patient with nonviral infection/inflammation is by no means a sign of a less inflammatory response. The increased state of leukocyte adhesiveness/aggregation might help to disclose the presence of inflammation in these individuals.

The Picture of Inflammation: A New Concept That Combines the White Blood Cell Count and Erythrocyte Sedimentation Rate into a New Hematologic Diagnostic Modality

“…The Inflammation Meter (INFLAMET™) [1, 2, 3, 4, 5, 6, 7, 8]. For analysis of the slides, we used an image analysis system (INFLAMET) consisting of a Pentium computer running Win 95, equipped with a Matrox Meteror color frame grabber, a color CCD camera and a microscope which was operated at ×200 magnification, resulting in an image resolution of 0.4 µm per pixel.…”

“…Using the peripheral blood slide test and image analysis we were able to adopt a new diagnostic concept that is based on the detection of the number of white blood cells (WBC), their state of adhesiveness/aggregation in the peripheral blood, as well as the determination of red blood cell aggregability [1, 2, 3, 4, 5, 6, 7, 8]. This approach has the advantage of obtaining simultaneous information on the degree of the leukocytic response and the intensity of the humoral acute phase response, the latter being characterized by the synthesis of multiple proteins, part of which can induce WBC [9]and red blood cell [10]aggregation.…”

“…Indeed, the degree of both leukocyte and erythrocyte adhesiveness/aggregation was shown to correlate significantly with other classical markers of the acute phase response, i.e. fibrinogen concentration and the erythrocyte sedimentation rate (ESR) or quantitative CRP [1, 2, 3, 4, 5, 6, 7, 8]. We now report our findings that show that a quantitative analysis of the above-mentioned phenomena is feasible, that the results obtained by our image analyzer reflect the intensity of the acute phase response, and that there is a high level of agreement between different observers in their assessment of the pictures and numeric data.…”

Rheological determinants in patients with Gaucher disease and internal inflammation

“…This test was performed on the same slides and image analysis system as described previously [17]. The image analysis system can detect and count white blood cells and determine the degree of adhesiveness/aggregation.…”

The Usefulness of an Inflammation Meter to Detect the Presence of Infection/Inflammation in Elderly Patients

“…Note : ESR ϭ erythrocyte sedimentation rate; CRP ϭ C-reactive protein. 3 , polymorphonuclears of 52%, an erythrocyte sedimentation rate of 4 mm/h, a fibrinogen concentration of 243 mg/dl, an erythrocyte adhesiveness/aggregation test result of 0.6, and a leukocyte adhesiveness/aggregation test result of 0%. B, A patient (with chest pain) with C-reactive protein level of 0.5 mg/l, a white blood cell count of 7200 per mm 3 , polymorphonuclears of 71%, an erythrocyte sedimentation rate of 16 mm/h, a fibrinogen concentration of 316 mg/dl, an erythrocyte adhesiveness/aggregation test result of 1.4, and a leukocyte adhesiveness/aggregation test result of 0%.…”