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Amikacin can be added to blood to reduce the fall in platelet count

Xiaomian Zhou1, Xiaoli Wu, Weixiong Deng

  • 1Dept. of Laboratory Medicine, Guangzhou First Municipal People's Hospital, Affiliate of Guangzhou Medical College, Guangzhou, PR China.

American Journal of Clinical Pathology
|September 16, 2011
PubMed

Insights

Amikacin effectively prevents pseudothrombocytopenia, a condition causing falsely low platelet counts due to anticoagulant-induced platelet clumping. This finding offers a novel solution for accurate platelet counts in affected patients.

Area of Science:

  • Hematology
  • Clinical Pathology
  • Pharmacology

Background:

  • Anticoagulant-dependent (AD) pseudothrombocytopenia is a spurious laboratory finding caused by platelet aggregation in collected blood samples.
  • This phenomenon can lead to misdiagnosis and inappropriate clinical management due to falsely low platelet counts.

Observation:

  • A case of multianticoagulant-dependent pseudothrombocytopenia was observed, where platelet clumping occurred with ethylenediaminetetraacetic acid (EDTA), sodium citrate, heparin, and sodium fluoride (NaF).
  • Microscopic evaluation confirmed massive platelet clumping in blood samples treated with these anticoagulants.

Findings:

  • Testing various reagents, including aminoglycosides like gentamicin and amikacin, vitamin B6, and aminophylline, revealed that only amikacin inhibited pseudothrombocytopenia.
  • Blood samples treated with amikacin within one hour of collection showed no platelet aggregation and maintained stable blood cell counts and indices for up to four hours at room temperature.

Implications:

  • Amikacin demonstrates potential as an effective agent to inhibit and dissociate platelet aggregation in multianticoagulant-dependent pseudothrombocytopenia.
  • This discovery could lead to improved diagnostic accuracy for patients with pseudothrombocytopenia, particularly those affected by multiple anticoagulants.

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