[Experimental analysis and countermeasures for EDTA-dependent Pseudothrombocytopenia].

Area of Science:

• Hematology
• Clinical Pathology

Background:

• EDTA-dependent pseudo-thrombocytopenia (EDTA-PTCP) is a frequently encountered artifact in routine blood counts.
• Accurate platelet quantification is essential for diagnosing and managing various hematological conditions.

Purpose of the Study:

• To determine the incidence of EDTA-PTCP in a hospitalized patient population.
• To evaluate diagnostic methods for differentiating true thrombocytopenia from EDTA-PTCP.
• To recommend strategies for avoiding misdiagnosis.

Main Methods:

• Analysis of 1326 thrombocytopenia cases among 71,535 hospitalized patients.
• Re-analysis of 87 EDTA-PTCP cases using sodium citrate anticoagulant.
• Microscopic examination of peripheral blood smears with Wright-Giemsa staining.

Main Results:

• The incidence of EDTA-PTCP caused by EDTA-K anticoagulant was 0.12% of all patients and 6.56% of thrombocytopenia cases.
• Platelet counts in EDTA-K samples were significantly lower ((56 ± 27)×10(9)/L) compared to sodium citrate samples ((185 ± 39)×10(9)/L).
• Microscopy revealed platelet aggregation in EDTA-PTCP samples.

Conclusions:

• EDTA-PTCP occurs in 0.12% of patients and is easily misdiagnosed.
• Specimens with platelet counts <100×10(9)/L warrant repeat testing.
• Using sodium citrate anticoagulant for re-testing suspected cases of platelet aggregation prevents misdiagnosis.