DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20203973

Pseudothrombocytopenia: early recognition avoids unnecessary intervention

Rajeshwari Narayanan, Prahada Jagannathan, Kala Kandhasamy

Abstract


Ethylenediaminetetraacetic acid dependent pseudothrombocytopenia (EDTA-PTCP) is the phenomenon of a spurious low platelet count due to EDTA induced aggregation of platelets. Failure to identify this can lead to unwarranted diagnostic testing, platelet transfusions and deferring emergency surgeries. An adolescent girl child was referred for acute febrile illness with thrombocytopenia. Peripheral smear examination of EDTA sample revealed platelet clumping. WBC and platelet histograms also supported the same. Repeat platelet counts in sodium citrate and heparin confirmed EDTA-PTCP.


Keywords


EDTA, Platelet clumping, Pseudothrombocytopenia

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References


Fang C, Chien Y, Yang L, Lu W, Lin M. EDTA-dependent pseudothrombocytopenia. Formosan J Surg. 2015;48(3):107-9.

Zandecki M, Genevieve F, Gerard J, Godon A. Spurious counts and spurious results on haematology analysers: a review. Part I: platelets. Int J Lab Hematol. 2007;29(1):4-20.

Cohen AM, Cycowitz Z, Mittelman M, Lewinski UH, Gardyn J. The incidence of pseudothrombocytopenia in automatic blood analysers. Haematol. 2000;30(8):117-21.

Gowland E, Kay HE, Spillman JC, Williamson JR. Agglutination of platelets by a serum factor in the presence of EDTA. J Clin Pathol. 1969;22:460-4.

Banfi G1, Salvagno GL, Lippi G. The role of ethylenediamine tetraacetic acid (EDTA) as in vitro anticoagulant for diagnostic purposes. Clin Chem Lab Med. 2007;45(5):565-76.

Lippi G, Plebani M. EDTA-dependent pseudothrombocytopenia: further insights and recommendations for prevention of a clinically threatening artefact. Clin chem lab med. 2012;50(8):1281-5.

Nagler M, Keller P, Siegrist D, Alberio L. A case of EDTA-dependent pseudothrombocytopenia: simple recognition of an underdiagnosed and misleading phenomenon. BMC Clin Pathol. 2014;14:19.

Ahn HL, Jo YI, Choi YS, Lee JY, Lee HW, Kim SR et al. EDTA-dependent pseudothrombocytopenia confirmed by supplementation of kanamycin; a case report. Korean J intern med. 2002;17(1):65-8.

Souza L, Amorim L, Pereira A. In-Hospital Onset of Pseudothrombocytopenia Days before Surgery. Case rep anesthesiol. 2018;2018:4726036.

Thomas ETA, Bhagya S, Majeed A. Clinical Utility of Blood Cell Histogram Interpretation. J clin diagn res. 2017;11(9):1-4.