Related Experiment Video
Updated: May 1, 2026
Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
Enhanced accuracy of optical platelet counts in microcytic anemia
Objective:
To determine whether microcytic erythrocytes influence the accuracy of automated platelet (PLT) counting.
Methods:
We divided a total of 206 K2 ethylenediaminetetraacetic acid (EDTA)-anticoagulated blood samples into 4 groups, as follows: In group 1 (control group), normal mean corpuscular volume (MCV > 80 fL) and PLT count equal or greater than 140,000/microL (n = 45); group 2, normal MCV, reduced PLT count (< 140 x 10(3)/microL, n = 41); group 3, microcytic samples with normal PLT count (n = 68); and group 4, microcytic samples with reduced PLT count (n = 49). We also compared the platelet counting using electroimpedance (PLT-EI), platelet count using fluorescent optical (PLT-FO), and platelet-count manual (PLT-M) methods, using the Sysmex XE 2100 automatic analyzer.
Results:
Despite highly significant overall correlations between PLT-EI and PLT-FO, PLT-EI and PLT-M, and PLT-FO and PLT-M (r = 0.95 [all P < .001]), use of the PLT-EI method resulted in widely overestimated PLT counts in microcytic samples (MCV < 80 fL), compared with use of PLT-FO and PLT-M. Our results identify an MCV of 70 fL as the critical threshold below which PLT-EI became unreliable.
Conclusion:
The PLT-EI mode overestimated PLT counts compared with PLT-FO and PLT-M modes in microcytic blood. Therefore, PLT-FO is the preferred method for PLT counting in patients with microcytic anemia when using an automated analyzer.
Insights
Microcytic erythrocytes can lead to overestimated automated platelet counts using the electroimpedance (PLT-EI) method. Fluorescent optical (PLT-FO) counting is more accurate for patients with microcytic anemia.
Area of Science:
- Hematology
- Clinical Pathology
- Laboratory Medicine
Background:
- Automated platelet counting is crucial for diagnosing and managing various hematological conditions.
- Microcytic erythrocytes, characterized by a low mean corpuscular volume (MCV), can potentially interfere with automated cell counting methods.
- Accurate platelet enumeration is essential for clinical decision-making.
Purpose of the Study:
- To evaluate the impact of microcytic erythrocytes on the accuracy of automated platelet (PLT) counting.
- To compare the performance of different automated platelet counting methods in the presence of microcytosis.
Main Methods:
- Analysis of 206 K2 EDTA-anticoagulated blood samples categorized into four groups based on MCV and PLT count.
- Comparison of platelet counts obtained by electroimpedance (PLT-EI), fluorescent optical (PLT-FO), and manual (PLT-M) methods using a Sysmex XE 2100 analyzer.
Main Results:
- Significant correlations were observed between all compared methods (PLT-EI, PLT-FO, PLT-M).
- The PLT-EI method consistently overestimated platelet counts in samples with microcytic erythrocytes (MCV < 80 fL).
- An MCV threshold of 70 fL was identified below which PLT-EI demonstrated unreliability.
Conclusions:
- Automated platelet counting using the electroimpedance method is unreliable in the presence of microcytic blood.
- The fluorescent optical (PLT-FO) method provides more accurate platelet counts in patients with microcytic anemia compared to PLT-EI.
- PLT-FO is recommended for platelet counting in microcytic patients when using automated analyzers.
