PB0369 - Haemocytometric characteristics of venous thrombo-embolism and erysipelas on an automated hematology analyser: a potential diagnostic tool?

Background: Both deep vein thrombosis (DVT), superficial vein thrombosis (SVT) and erysipelas induce cellular inflammation. This results in overlapping symptoms such as pain, swelling, and redness, making a clinical diagnosis without additional testing difficult. Based on our earlier observation that cellular inflammation can be a diagnostic tool for infectious diseases, we questioned whether this could assist in differentiating between thrombosis and erysipelas.

Aims: To explore whether cellular inflammation, evaluated using an automated hematology analyser, could serve as a diagnostic tool in DVT, SVT and/or erysipelas.

Methods: We measured 211 haemocytometric parameters, including size, DNA/RNA-content, and internal cell structure, using widely available automated hematology analysers. Blood samples were obtained on day of diagnosis. Patients with hematologic malignancies or auto-immune diseases were excluded. The study was approved by the Medical Ethics Committee and informed consent was waved due to its retrospective nature.

Results: We included 58 patients with DVT, 35 with SVT, 36 with erysipelas and 34 controls. DVT was associated with lower neutrophil [OR 0.61; 95%CI:0.49-0.76;p < 0.001] and monocyte count [OR 0.20; 95%CI:0.05-0.77;p=0.019], larger monocytes (MO-FSC) [OR 1.70; 95%CI:1.30-2.21;p < 0.001] and less granularity (MO-SSC) [OR 0.59; 95%CI:0.47-0.76;p < 0.001] compared to erysipelas (Figures 1 and 2). Compared to controls, DVT was associated with higher neutrophil count and MO-SSC. Lymphocyte count and granularity (LY-SSC) were higher in DVT compared to erysipelas. Reactive lymphocyte count (RE-LYMPHO) was lower in DVT as compared to controls. In contrast to DVT, SVT was associated with lower neutrophil count, monocyte count and LY-SSC.

Conclusion(s): In this exploratory study we found that in erysipelas systemic cellular inflammation, evaluated with widely available hematology analysers, was more intense as compared to the low-grade ongoing inflammation in DVT. In comparison, systemic inflammation was less pronounced in SVT. These findings may serve as a promising basis to further explore the potential of haemocytometric parameters as diagnostic tool.