Spuriously Elevated Platelet Counts due to Microspherocytosis

Akwari, Anne M.; Ross, Dennis W.; Stass, Sanford A.

doi:10.1093/ajcp/77.2.220

Cited by 30 publications

(22 citation statements)

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“…Spuriously high platelet counts determined by automated cell counting were found previously in certain diseases, including microspherocytosis [6], leukemia [7], and hemolytic uremic syndrome [8] as well as in blood salvaged for autotransfusion [2,3]. In the present study the platelet counts obtained by the flow-cytometric analysis were 2.3 to 12 times lower than the figures stated in former studies concerning intra -and postoperative autotransfusion (table 1).…”

Section: Discussioncontrasting

confidence: 49%

Routine Automated Laboratory Methods Are Inadequate to Determine the Number of Platelets in Blood Salvaged and Processed for Autotransfusion

Lorentz¹,

Waibel²,

Becker³

et al. 2000

Transfus Med Hemother

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Objective: To determine the true platelet count in blood salvaged and processed for autotransfusion. Design: Prospective, randomized study. Setting: Department of anesthesiology and orthopedic clinic of a university hospital. Patients: 60 patients who were scheduled for elective hip surgery and included in routine intra- and postoperative blood salvage and autotransfusion programs. Interventions: Patients were randomly divided into 2 groups. In group I (n = 30) autotransfusion was performed using the Continuous Autotransfusion System^® (Fresenius), in group II (n = 30) the Cell Saver 5^® (Haemonetics) was used. In both groups samples were taken from the collection reservoir and the washed red cells. Platelet counts were performed with an automated cell analyzer and by flow-cytometric analysis using the monoclonal antibody CD42a. Results: The platelet counts obtained by the automated analyzer were 5 to 21 times higher than those obtained by flow-cytometric analysis. This appears to be due to the contamination of the samples with cell debris of about the same size as platelets. The platelet counts stated in literature should be reconsidered. Conclusions: Automatic cell-counting devices are inadequate to determine the platelet count of blood salvaged and processed for autotransfusion.

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Section: Discussioncontrasting

confidence: 49%

Routine Automated Laboratory Methods Are Inadequate to Determine the Number of Platelets in Blood Salvaged and Processed for Autotransfusion

Lorentz¹,

Waibel²,

Becker³

et al. 2000

Transfus Med Hemother

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“…Também é importante averiguar a presença de fragmentos eritrocitários, fragmentos citoplasmáticos de células leucêmicas, lipemia, bactérias, leveduras e micrócitos com volume próximo ao limite de corte ou threshold, que é o limiar volumétrico de distinção entre eritrócitos e plaquetas nos analisadores hematológicos, pois estes fatores podem conduzir a resultados falsamente aumentados na CAP. [21][22][23][24] A avaliação microscópica das plaquetas é igualmente importante nos pacientes com trombocitose para procurar evidências de uma doença mieloproliferativa. 25 De um modo geral, o principal erro das estimativas plaquetárias está em subestimar as contagens automatizadas pelo fato de que, em altas e baixas contagens, as plaquetas que estão sob os eritrócitos e não foram enumeradas geram maior imprecisão.…”

Section: Discussionunclassified

Contagem de plaquetas: avaliação de metodologias manuais e aplicação na rotina laboratorial

Comar¹,

Danchura²,

Silva³

2009

Rev. Bras. Hematol. Hemoter.

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IntroduçãoA plaqueta sanguínea, que possui formato discoide e estrutura altamente complexa, é um fragmento do citoplasma do megacariócito com enorme conteúdo energético e que desempenha funções hemostáticas insubstituíveis. 1 A descrição das plaquetas como corpúsculos distintos do sangue e seu envolvimento no mecanismo de coagulação sanguínea in vivo foi primeiramente descrito pelo patologista italiano Giulio Bizzozero em 1882. 2As plaquetas circulam na corrente sanguínea durante sete a dez dias e quase um trilhão delas circula em um humano adulto, o qual produz aproximadamente 100 bilhões de plaquetas por dia. 3Trombocitopenia define circunstâncias associadas com a circulação diminuída das plaquetas e são mais comuns do que aquelas associadas com circulação aumentada das mesmas, situação conhecida como trombocitose. Considerando que estados trombocitopênicos são associados frequentemente com sangramento mucocutâneo, a trombocitose pode ser associada com risco trombótico aumentado, particularmente na circulação arterial. 1 A contagem de plaquetas por microscopia (CPM) é uma ferramenta fundamental na avaliação dos pacientes com doenças que acometem as plaquetas na medida em que adiciona informações úteis àquelas obtidas pelos analisadores hematológicos, além de servir de ferramenta de

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“…1 Spurious elevation of the platelet count has been reported when nonplatelet material such as cytoplasmic fragments of RBCs and WBCs are enumerated erroneously as platelets. [2][3][4][5][6][7] Other reports of interference with the platelet count on some of the newer large-volume hematology analyzers include autoagglutinins, cryoglobulins, cold agglutinins, platelet satellitosis, platelet clumps, giant platelets, microcytic RBCs, malaria-infected RBCs, bacteria, and leukemic cell fragments in the tumor lysis syndrome. [8][9][10][11][12] The Cell-DYN 4000 uses optical scatter and electrical impedance to count and size platelets.…”

Section: Discussionmentioning

confidence: 99%

Spurious Automated Platelet Count

et al. 2003

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We recently encountered a patient with thrombocytopenia secondary to multiple drug therapy, disseminated prostatic adenocarcinoma, and sepsis who had a sudden decrease in his platelet count as enumerated by the Cell-DYN 4000 hematology analyzer (Abbott Diagnostics, Santa Clara, CA). A manual platelet count performed thereafter was even lower. The etiology of the spurious platelet count was clarified when numerous yeast forms were observed on routine microscopy of the peripheral blood smear. Subsequently, these organisms were identified as Candida glabrata from a positive blood culture (BACTEC 9240, Becton Dickinson, Cockeysville, MD). To our knowledge, this is the first report of spurious enumeration of yeast forms as platelets in an automated hematology system. The principle underlying platelet enumeration by the Cell-DYN 4000 system and other hematology analyzers and the value of microscopy on peripheral smears with unexpected CBC count results are discussed.

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Spuriously Elevated Platelet Counts due to Microspherocytosis

Cited by 30 publications

References 0 publications

Routine Automated Laboratory Methods Are Inadequate to Determine the Number of Platelets in Blood Salvaged and Processed for Autotransfusion

Routine Automated Laboratory Methods Are Inadequate to Determine the Number of Platelets in Blood Salvaged and Processed for Autotransfusion

Contagem de plaquetas: avaliação de metodologias manuais e aplicação na rotina laboratorial

Spurious Automated Platelet Count

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