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Pseudoplatelets: a retrospective study of their incidence and interference with platelet counting
W van der Meer1, M A MacKenzie, J W B Dinnissen
1Department of Clinical Chemistry, University Medical Centre St Radboud, 6500 HB Nijmegen, The Netherlands. w.vandermeer@akc.umcn.nl
Aims:
Spurious platelet counts can be found in acute leukaemias, as a result of the fragmentation of blood cells. Microscopic examination of a blood smear should be performed to detect the presence of these so called pseudoplatelets. When present, the platelet count should be corrected because of the important clinical consequences that a lower platelet count may have in these patients.
Methods:
K(3)EDTA anticoagulated blood was measured on an automated blood cell counter, and a blood smear was made and stained according the May Grünwald-Giemsa method for microscopic observation. A 500 cell/particle differentiation was performed and the automated platelet count was corrected.
Results:
The incidence of pseudoplatelets in 169 patients with acute leukaemia was studied. Pseudoplatelets were detected in 43 patients (25.4%), and seven patients (4.1%) were re-classified as having a major bleeding risk (platelet count, < 15 x 10(9)/litre).
Conclusions:
Platelets should be determined morphologically in patients with acute leukaemia and a routine screening method for the detection of pseudoplatelets should be developed.