Pseudothrombocytopenia is an in vitro phenomenon of platelet aggregation due to conformational changes and exposure of cryptic antigens on the platelet surface caused by anticoagulants, leading to the aggregation of platelets and falsely lower automated platelet counts. Although it has no clinical relevance, it can lead to unnecessary fear, diagnostic errors, or unnecessary tests and interventions when unrecognized. Pseudothrombocytopenia was detected in a 25-year-old woman 8 months after the second dose of mRNA COVID-19 vaccine, BNT162b2. The pseudothrombocytopenia was transient and the duration was shorter than 3 months. As pseudothromobocytopenia is not detected unless blood is drawn for other objectives, it is difficult to determine its true occurrence among recipients of vaccines. This case shows that pseudothrombocytopenia may develop transiently even months after COVID-19 vaccination and should be considered when thrombocytopenia is found in recipients of the vaccine to avoid unnecessary fear, diagnostic errors, or unnecessary tests and interventions.
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| http://dx.doi.org/10.1093/labmed/lmac031 | DOI Listing |
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Interpretation of pseudothrombocytopenia using platelet histograms and flags in a hematology autoanalyzer in a healthy child: a case report.
Turk J Pediatr
November 2024
Department of Pediatric Hematology, Faculty of Medicine, Gazi University, Ankara, Türkiye.
Background: Pseudothrombocytopenia is a spurious thrombocytopenia caused mostly by ethylenediaminetetraacetic acid (EDTA) use, and if detected early, unnecessary testing and treatment can be avoided. We present pseudothrombocytopenia caused by EDTA and citrate in an asymptomatic healthy child, as well as the value of using peripheral blood smear, platelet histogram, and flag data.
Case: A previously healthy 13-year-old girl with thrombocytopenia who developed tonsillitis 12 days previously was referred to our hematology department.
National recommendations of the Croatian Chamber of Medical Biochemists and Working group for Laboratory hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine: Management of samples with suspected EDTA-induced pseudothrombocytopenia.
Biochem Med (Zagreb)
October 2024
Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia.
Article Synopsis
- Pseudothrombocytopenia (PTCP) is a rare issue where platelet counts appear low due to aggregation, leading to possible misdiagnoses and unsafe clinical decisions if not recognized quickly.
- The most frequent cause of PTCP is ethylenediaminetetraacetic acid (EDTA), and there are various management strategies documented, though expert guidance is limited.
- A collaborative group in Croatia developed minimal recommendations to help standardize the detection and reporting of platelet counts from EDTA-induced PTCP, aimed at laboratory professionals and healthcare providers involved in blood sample management.
Definition of Significant Platelet Clumping: Should We Review All Samples With a Platelet Clumping Flag From Automated Hematology Analyzer?
Int J Lab Hematol
February 2025
Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Objectives: This study aimed to determine a definition for significant platelet clumping (PC) and evaluate the performance of the Sysmex XN instrument for detecting platelet clumps.
Methods: For part 1, 372 specimens with a 'PLT_clump?' flag in XN-9000 were classified into five groups according to the average number of PCs. We compared the initial platelet count (measured by XN-9000 using impedance method) and corrected platelet count (counted optically or re-analyzed by XN-9000 using vortexed or re-collected sample) of each group.
Reliability of the DI-60 Digital Image Analyzer for Detecting Platelet Clumping and Obtaining Accurate Platelet Counts.
Ann Lab Med
November 2024
Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Pseudothrombocytopenia caused by platelet clumping (PC) can lead to unnecessary platelet transfusions or underdiagnosis of hematologic neoplasms. To overcome these limitations, we assessed the capacity of the Sysmex DI-60 digital morphology analyzer (Sysmex, Kobe, Japan) for detecting PC and determining an accurate platelet count in the presence of PC. For this purpose, 135 samples with or without PC (groups Y and N, respectively) were processed by an examiner (a hematologic specialist) using both the Sysmex XN-9000 and DI-60 analyzers.
View Article and Find Full Text PDFBackground: The rapid development of automatic blood cell analyzers has greatly optimized complete blood count results. However, erroneous results relevant to automatic blood cell analyzers still exist. Pseudothrombocytopenia can be observed in both cases of anticoagulant-induced platelet aggregation, and the presence of large and giant platelets.
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