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Updated: May 4, 2026
Analyzing Platelet Subpopulations by Multi-color Flow Cytometry
Published on: June 10, 2025
Two cases of false platelet clumps flagged by the automated hematology analyzer Sysmex XE-2100
Qingkai Dai1, Ge Zhang1, Chunqi Lai1
1Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, China.
Background:
Automated hematology analyzer is widely used by clinical laboratories to examine blood cell counts and differential leukocyte counts. However, a microscopic examination of a well-prepared blood film is still necessary and useful in most cases.
Methods:
Two patients with severe disease were required complete blood counts (CBC) after admission at West China Second University Hospital in Southwest China.
Results:
A false "platelet clumps?" flag was generated by the automated hematology analyzer Sysmex XE-2100. However, when the well-prepared blood film was reviewed, there was echinocytosis rather than clumps of platelets. In addition, both patients had severe metabolic acidosis with arterial blood pH <7.00 and HCO3- <4 mmol/l. On day 2 of admission, the false platelet clumps flags were not presented in both cases.
Conclusions:
Our further results suggested that the false platelet clumps had been flagged probably due to the influence of the extremely low blood pH. These two cases emphasized that a microscopic examination of a blood film was central to the morphology of blood cells. When the result of microscopic examination was abnormal, it was suggested that the physician should consider further testing to find underlying condition.
