MgSO<sub>4</sub> anticoagulant prevents pseudothrombocytopenia by preserving the integrity of the platelet GPIIb‐IIIa complex

Scavone, Mariangela; Bossi, Elena; Podda, Gian Marco; Cattaneo, Marco

doi:10.1111/bjh.17298

Cited by 3 publications

(3 citation statements)

References 17 publications

(23 reference statements)

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“…Magnesium sulfate does not cause GP IIb/IIIa dissociation by preventing the exposure of the hidden GP IIb component and maintaining the integrity of the complex. This prevents the binding of EDTA-dependent antiplatelet antibodies to the gp IIb subunit, resulting in a reduction in platelet clump formation [ 34 ]. It has also been noted that prewarming blood samples to 37 o C and adding kanamycin to the sample reduces platelet clumping and PTCP [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…Potential approaches include repeat CBC, again in an EDTA sample, but immediately after sampling, 10 and repeat CBC in samples in alternative anticoagulants, allowing for storage at RT. [11][12][13] However, the accuracy of these approaches has not been established yet. We compared the accuracy and stability of platelet counts in blood samples of PTP subjects, collected in four different anticoagulants and measured immediately after sampling and at predefined time points during storage at RT.…”

Section: Time-dependent In Vitro Variations Of Platelet Count In Samp...mentioning

confidence: 99%

Time‐dependent in vitro variations of platelet count in samples from subjects with EDTA‐induced pseudothrombocytopenia: A comparative analysis across different anticoagulants

Ghali,

Scavone,

Clerici

et al. 2024

Br J Haematol

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“…Pseudothrombocytopenia is a state in which platelets agglutinate in vitro, causing the hemocytometer to yield a low platelet count. While pseudothrombocytopenia is considered to occur most commonly due to antibodies recognizing GPIIb/IIIa that has undergone structural alteration in the presence of EDTA [ 72 , 73 ], platelets can also agglutinate in the presence of citrate and blood collection with heparin, though the detailed mechanism of agglutination has not yet been determined [ 74 ]. It is important to confirm the presence of platelet aggregates in a peripheral blood smear.…”

Section: Diagnostic Procedures (Fig 1 )mentioning

confidence: 99%

Reference guide for the diagnosis of adult primary immune thrombocytopenia, 2023 edition

Kashiwagi,

Kuwana,

Murata

et al. 2023

Int J Hematol

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Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia due to accelerated platelet destruction and impaired platelet production. Diagnosis of ITP is still challenging because ITP has been diagnosed by exclusion. Exclusion of thrombocytopenia due to bone marrow failure is especially important in Japan because of high prevalence of aplastic anemia compared to Western countries. Hence, we propose a new diagnostic criteria involving the measurement of plasma thrombopoietin (TPO) levels and percentage of immature platelet fraction (RP% or IPF%); 1) isolated thrombocytopenia with no morphological evidence of dysplasia in any blood cell type in a blood smear, 2) normal or slightly increased plasma TPO level (< cutoff), 3) elevated RP% or IPF% (> upper limit of normal), and 4) absence of other conditions that potentially cause thrombocytopenia including secondary ITP. A diagnosis of ITP is made if conditions 1-4 are all met. Cases in which criterion 2 or 3 is not met or unavailable are defined as “possible ITP,” and diagnosis of ITP can be made mainly by typical clinical course. These new criteria enable us to clearly differentiate ITP from aplastic anemia and other forms of hypoplastic thrombocytopenia and can be highly useful in clinical practice for avoiding unnecessary bone marrow examination as well as for appropriate selection of treatments.

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MgSO₄ anticoagulant prevents pseudothrombocytopenia by preserving the integrity of the platelet GPIIb‐IIIa complex

Cited by 3 publications

References 17 publications

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

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

Time‐dependent in vitro variations of platelet count in samples from subjects with EDTA‐induced pseudothrombocytopenia: A comparative analysis across different anticoagulants

Reference guide for the diagnosis of adult primary immune thrombocytopenia, 2023 edition

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MgSO4 anticoagulant prevents pseudothrombocytopenia by preserving the integrity of the platelet GPIIb‐IIIa complex

Cited by 3 publications

References 17 publications

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

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

Time‐dependent in vitro variations of platelet count in samples from subjects with EDTA‐induced pseudothrombocytopenia: A comparative analysis across different anticoagulants

Reference guide for the diagnosis of adult primary immune thrombocytopenia, 2023 edition

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MgSO₄ anticoagulant prevents pseudothrombocytopenia by preserving the integrity of the platelet GPIIb‐IIIa complex