EDTA‐induced pseudothrombocytopenia in hematopoietic stem cell donor

In healthy peripheral blood stem cell (PBSC) donors, rare cases of transient thrombocytopenia have been reported due to the administration of granulocyte colony-stimulating factor (G-CSF) or the apheresis itself. Meanwhile, differentiating pseudothrombocytopenia induced by anticoagulants is crucial, as it can result in false low platelet counts. This study aimed to investigate the causes of thrombocytopenia in healthy PBSC donors. We investigated PBSC donors who experienced thrombocytopenia during transplantation at St. Mary's Hospital, Seoul. Three donors were identified and donor workup studies were within the normal limits. After G-CSF administration prior to transplantation, the donors experienced a significant reduction in platelet counts. Apheresis resulted in lower levels, yet platelet counts returned to normal levels approximately two weeks later. In donor 3, thrombocytopenia was seen during the donor workup and ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia was identified after the supplementation of amikacin. For donor 3, we investigated whether his recipient's sample showed EDTA-induced pseudothrombocytopenia through a review of any platelet clumping in the apheresis product and the presence of immunoglobulin M (IgM) or IgG antiplatelet antibodies in the recipient's peripheral blood. In conclusion, the risk of severe thrombocytopenia with G-CSF administration in PBSC donors should be considered and accurate differentiation of pseudothrombocytopenia is imperative.

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Ethylene Diamine Tetra Acetate-Induced Pseudo Thrombocytopenia (EDTA-PTCP) in an Adolescent: A Case Report

Tangella,

Peta,

Yadlapalli

et al. 2023

Cureus

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Ethylene diamine tetra acetate-induced pseudo thrombocytopenia (EDTA-PTCP) is a fictitious laboratory condition that is associated with platelet clumping, leading to falsely low platelet counts. This fictitious occurrence can lead to expensive, time-consuming, and invasive diagnostic procedures. It may also result in the application of unnecessary therapies, although it is not linked to any hemorrhagic symptoms or platelet malfunction. This emphasizes the necessity of verifying laboratory results from automated analyzers in every patient with thrombocytopenia with a peripheral smear, particularly when they are out of proportion when compared to the clinical features. When using hematology analyzers, EDTA-induced pseudo thrombocytopenia can be missed. In cases of isolated thrombocytopenia, this can be easily avoided by performing a simple visual peripheral blood smear check, hence making it an important differential for thrombocytopenia on an automatic analyzer report, which has to be ruled out. Here, we present the case of an adolescent who presented to us with low platelet counts and was diagnosed with EDTA-PTCP after proper evaluation.

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EDTA‐induced pseudothrombocytopenia in hematopoietic stem cell donor

Cited by 3 publications

References 9 publications