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False positive Kleihauer results: an unusual cause in a postnatal patient in remission from acute myeloid leukaemia
Author(s) -
GRANT R.,
KEIDAN J.
Publication year - 2009
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/j.1751-553x.2007.00974.x
Subject(s) - medicine , complete remission , myeloid leukaemia , pregnancy , population , malignancy , myeloid , false positive paradox , immunology , pediatrics , obstetrics , chemotherapy , biology , genetics , environmental health , machine learning , computer science
Summary A 34‐year‐old woman, in remission from acute myeloid leukaemia, had a positive postnatal Kleihauer result. Following our standard local protocol for positive Kleihauer tests in Rh‐D negative patients, the specimen was referred for confirmatory testing, which proved the result to be false positive. Hereditary persistence of foetal haemoglobin was excluded as a Kleihauer test performed in a pregnancy prior to the development of leukaemia was negative. Further testing confirmed mild elevation of foetal haemoglobin (HbF) and increased F‐cells. Elevated‐HbF levels have been widely reported in patients with haematological malignancy. In this case, the patient was confirmed to be in a true molecular remission from leukaemia and yet appeared to have a residual clonal population of HbF erythrocytes; the significance of this finding remains unclear. This case also highlights the importance of confirmatory testing of suspected foeto‐maternal haemorrhage, as not all positive Kleihauer tests are true positives.