Budiono Raharjo, Solichul Hadi


 Sysmex XN-1000 hematology analyzer is an automated 5-part diff analyzer (eosinophils, basophils, neutrophils, lymphocytes, and monocytes). In the calculated area, the type of difference between the Sysmex hematology device and other hematology devices is Immature Granulocyte (IG), Nucleated Red Blood Cell (NRBC), and High Fluorescent Lymphocytes Count (HFLC). The cells calculated in the HFLC area are atypical lymphocytes. In patients with dengue hemorrhagic fever, it is often found atypical lymphocytes called blue plasma lymphocytes. The purpose of this study was to determine the description of HFLC in patients with dengue fever using the hematology analyzer Sysmex XN-1000. A descriptive retrospective study was conducted during April-May 2017. The subjects of the study were adult patients diagnosed with dengue hemorrhagic fever with WHO criteria. Of the 47 samples of Dengue Hemorrhagic Fever (DHF) patients, the average HFLC results were between 2.0-32.3%, which was 11.5%, while the average range of normal HFLC values was between 0.0-1.4% and was 0.3%. In cases of DHF, there is an increase in HFLC. This is likely to be attributed to atypical lymphocyte increase in dengue hemorrhagic fever. Further research with more varied samples still needs to be done.


High fluorescent lymphocytes count, dengue hemorrhagic fever, atypical lymphocytes

Full Text:



Longanbach S, Miers MK. Automated Blood Cell Analysis. In: Keohane EM, Smith LJ, Walenga JM. Rodak Hematology: Clinical Principle and application. 5th ed. Elsevier. 2016. p208-28.

Instrumentation in hematology. In: Turgeon ML. Clinical Hematology Theory and Procedures. 5th ed. Lippincott Williams and Wilkins. 2011. p546-54.

Zsandencki M, Genevieve F, Gerard J, Gordon A. Spurious counts and spurious result on hematology analyzer: white blood cells, red blood cells, hemoglobin, red cell indices, and reticulocytes. In: Marchant KK, Davis BH. Laboratory hematology practice. 2012. Willey Black p.79-82.

Instrumentation in hematology. In: Turgeon ML. Clinical hematology: Theory and Practices. 6th ed. 2017. p619-36.

Meintker L, Ringwald J, Rauh M, et al. Comparison of automated differential blood cell counts from abbott saphire, siemens advia 120, Beckman coulter DxH 800, and sysmex XE-2100 in normal and pathologic samples. 2013. Am J Clin Pathol; 139,641-50.

Sysmex. Counting of highly fluorescent lymphocytes (HFLC) as antibody-producing plasma cells on XE-5000. Sysmex extra online. 2011.p1-8.

Chandra A. Demam berdarah dengue: epidemiologi, patogenesis, dan faktor risiko penularan. Aspirator. 2010; 2(2):110-119.

Irianti DM, Reniarti L, MS A. Hubungan jumlah limfosit plasma biru dengan spektrum klinis dan perannnya dalam memprediksi perubahan spektrum klinis infeksi dengue pada anak. Sari pediatri. 2009 ;10(5):325-30.

Tjahjono G, Nasronudin. Imunopatogenesis demam berdarah dengue. In: Nasronudin. Penyakit infeksi di indonesia. 2nd ed. Airlangga university press. 2011. P117-122.

Linssen J, Jennissen V, Hildmann J, Reisinger E, Schindler J,et al. Identification and Quantification of High-Fluorescence-Stained Lymphocytes as Antibody Synthesizing/Secreting Cells Using the Automated Routine Hematology Analyzer XE2100. Clinical Cytometry Society. 2017;72B:157–166.

DOI: http://dx.doi.org/10.24293/ijcpml.v25i2.1443


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.