DOI: 10.36347/sjams.2019.v07i12.048

Pages: 4073-4076

Malaria being one of the most common parasitic disease worldwide, places a significant burden on the health care system. Hemozoin is known to be an end-product of hemoglobin digestion by malaria parasite. It is a birefringent crystal, and thus hemozoin-containing white blood cells (WBCs) may show the atypical light scattering pattern. The purpose of this study was to investigate pseudoeosinophilia associated with malaria infection using a Sysmex XN-1000 hematology analyzer (Sysmex Corporation, Kobe, Japan). Sysmex XN-1000 automated hematology analyzer was used to analyze EDTA anticoagulated samples of 25 patients with malaria infection. Leishman stained peripheral smears were also examined. Out of 25 cases studied, 24% showed erroneously high eosinophil counts and atypical eosinophil distributions in the WBC scattergram, which was due to the presence of hemozoin-containing neutrophils. In three patients, their erroneously high eosinophil counts declined as the parasitemia decreased with treatment. In conclusion, hematologists should consider the possibility of pseudoeosinophilia as a result of hemozoin-containing WBCs and confirm the WBC differential count by microscopy.