The incidence of pseudothrombocytopenia in automatic blood analyzers

Am, Cohen; Cycowitz, Z; Mittelman, Moshe; Uh, Lewinski; Gardyn, Joseph

doi:10.1163/15685590051130137

Cited by 45 publications

(34 citation statements)

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“…Hastaya refrakter trombositopeni tanısıyla steroid tedavisi verildi. Ancak genel durumu çok iyi olmasına rağmen trombositopenisi sürdüğünden tedavinin beşinci gününde periferik kan yayması yapıldı ve her alanda [10][11][12] …”

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“…Psödotrombositope-niye yol açma mekanizması tam olarak netleşmemiştir; ancak glikoprotein IIb/IIIa kompleksinin EDTA varlığında antikorlar tarafından tanındığına dair bir hipotez ileri sürülmüştür (4,9). EDTA'ya bağlı psödotrombositopeni rutin sağlık hizmeti veren hastanelerde %0.1 oranında saptanabilirken, trombositopeni etyolojisinin araştırıldığı merkezlerde bu oran %15-17'leri bulabilmektedir (7,10,11). Bu sonucun bu kadar yüksek olması, periferik yaymanın yapılmamasına ve kanların uzun süre bekletildikten sonra çalışılmasına bağlanmıştır.…”

Section: İrdelemeunclassified

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EDTA-Dependent Pseudothrombocytopenia and Unnecessary Transfusion in a Patient with Crimean-Congo Haemorrhagic Fever

Canpolat¹,

Tufan²,

Bulut³

et al. 2012

Klimik Dergisi

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Section: öZetunclassified

Section: İrdelemeunclassified

EDTA-Dependent Pseudothrombocytopenia and Unnecessary Transfusion in a Patient with Crimean-Congo Haemorrhagic Fever

Canpolat¹,

Tufan²,

Bulut³

et al. 2012

Klimik Dergisi

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“…Th erefore, the number of platelets provided on HA represents the sum of the number of free nonagglutinated platelets and platelets of small agglutinates (3)(4)(5), although the actual number of platelets is within normal values (Table 1) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Undiagnosed pseudothrombocytopenia may lead to unnecessary aggressive diagnostic procedures such as biopsy or puncture of the bone marrow, inadequate treatment and even transfusion of platelets [3,5,6].…”

Section: Introductionmentioning

confidence: 99%

Pseudothrombocytopenia

Nikolić¹,

Suvajdzic-Vukovic²,

Plecas³

2016

Hosp Pharm Int Multi J

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SUMMARYIntroduction: Pseudo thrombocytopenia (PTP) is a phenomenon of falsely low platelet counts obtained on Hematology Analyzers (HA) due to in vitro platelet clumping in the presence of anticoagulants. Methods: Papers on the subject of pseudothrombocytopenias eff ects were searched for in biomedical journals indexed in MEDLINE from 1969 to 2016. All other thrombocytopenia types were not analyzed. Topic: Pseudothrombocytopenia occurs using the EDTA and other anticoagulants, in the process of determining the platelet count on the HA. Agglutination of platelets occurs at temperatures lower than 34˚C and sample enhances if exposed to longer period of time. Agglutination of platelets is most expressed 4 hours after blood sampling. Agglutination occurs by binding of IgM, IgG and IgA immunoglobulin to antigen or crypto-antigen of platelets. Hematologic cell Analyzers, (HA) do not count platelets from large agglutinations, therefore, the number of platelets that provides HA represents the sum of the number of free non-agglutinating platelets and small agglutinations consisting of 3-5 platelets. Pseudothrombocytopenia shall be suspected in the case of the absence of clinical signs of hemorrhagic diathesis. Undiagnosed pseudothrombocytopenia may lead to unnecessary aggressive diagnostic procedures such as biopsy or puncture of the bone marrow, inadequate treatment and even transfusion of platelets. The fallowing types of pseudothrombocytopenias are described herein: a) pseudothrombocytopenia occurred due to platelet agglutination, b) platelet satellitism and c) aggregation of platelets and leukocytes. Conclusion: In order to obtain the actual count of platelets, peripheral blood smear shall be done for all samples with low values of thrombocytes (<100x10 9 / L), and for samples of the results having fl ags on HA. In the case of fi nding agglutinated platelets, the following measures should be taken in order to obtain correct interpretation of laboratory results: to warm blood sample at 37° C and re-test, to test the blood sample on the another anticoagulant (citrate, heparin), to make blood smear, and to determine the platelets using ammonium oxalate by counting platelets from capillary blood in microscopic counting chamber. In case of all phenomena of agglutinations with all the previously mentioned anticoagulants is only possible to use magnesium sulphate and to make smears on the site of capillary blood sampling. Using this method is as well possible to detect agglutination of platelets without using anticoagulants, which indicates the presence of cold agglutinins.

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“…This analysis allows us to distinguish important changes to diagnose due to the peculiarity presented by some blood diseases (1) .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of unnecessary laboratory tests and related avoidable costs in intensive care unit

Oliveira¹,

Oliveira²,

Souza³

2014

Jornal Brasileiro De Patologia E Medicina Laboratorial

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Introduction: The most common cause of diagnostic error is related to errors in laboratory tests as well as errors of results interpretation. In order to reduce them, the laboratory currently has modern equipment which provides accurate and reliable results. The development of automation has revolutionized the laboratory procedures in Brazil and worldwide. Objective: To determine the prevalence of microscopic changes present in blood slides concordant and discordant with results obtained using fully automated procedures. Materials and method: From January to July 2013, 1,000 hematological parameters slides were analyzed. Automated analysis was performed on last generation equipment, which methodology is based on electrical impedance, and is able to quantify all the figurative elements of the blood in a universe of 22 parameters. The microscopy was performed by two experts in microscopy simultaneously. Results: The data showed that only 42.70% were concordant, comparing with 57.30% discordant. The main findings among discordant were: Changes in red blood cells 43.70% (n = 250), white blood cells 38.46% (n = 220), and number of platelet 17.80% (n = 102). Discussion: The data show that some results are not consistent with clinical or physiological state of an individual, and cannot be explained because they have not been investigated, which may compromise the final diagnosis. Conclusion: It was observed that it is of fundamental importance that the microscopy qualitative analysis must be performed in parallel with automated analysis in order to obtain reliable results, causing a positive impact on the prevention, diagnosis, prognosis, and therapeutic follow-up.

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The incidence of pseudothrombocytopenia in automatic blood analyzers

Abstract: PTCP should be considered in the assessment of low platelet count. While decreasing the transfer time of blood specimens may decrease PTCP incidence, microscopic inspection of the blood smear may avoid erroneous diagnosis of thrombocytopenia.

Cited by 45 publications

References 0 publications

EDTA-Dependent Pseudothrombocytopenia and Unnecessary Transfusion in a Patient with Crimean-Congo Haemorrhagic Fever

EDTA-Dependent Pseudothrombocytopenia and Unnecessary Transfusion in a Patient with Crimean-Congo Haemorrhagic Fever

Pseudothrombocytopenia

Prevalence of unnecessary laboratory tests and related avoidable costs in intensive care unit

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