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Magnesium Sulfate as an Alternative In Vitro Anticoagulant for the Measurement of Platelet Parameters?
Steffen Mannuß1, Peter Schuff-Werner2, Katrin Dreißiger1
1From the Rostock University Medical Centre, Institute of Clinical Chemistry and Laboratory Medicine, Rostock, Germany.
Objectives:
There are conflicting reports on the reliable measurement of platelet count and mean platelet volume (MPV) using EDTA or citrate. The anticoagulant properties of magnesium sulfate (MgSO4) are known from the literature. The aim of this study was to evaluate MgSO4 as an in vitro anticoagulant for platelet count, MPV, platelet distribution width, and platelet activation.
Methods:
Whole blood from volunteers was anticoagulated by EDTA, citrate, or MgSO4 Platelets were counted by the XE 5000 (Sysmex, Norderstedt, Germany) impedance and fluorescence optical technique.
Results:
The mean impedance platelet counts were 227.7, 197.0, and 201.1 × 10(9)/L in EDTA-, citrate-, or MgSO4-anticoagulated blood, respectively. The counts were 4.7% higher (EDTA) after 3 hours of storage but 4% lower in citrate-anticoagulated blood. The counts in magnesium samples remained stable. The MPV was 10.4 fL (EDTA), 9.5 fL (citrate), and 9.3 fL (MgSO4). EDTA samples showed cell swelling within the first 3 hours. This was lower in citrate and only marginal in magnesium samples. High activation of platelets was observed only in EDTA samples.
Conclusions:
Magnesium anticoagulation might be advantageous for more reliable MPV measurements. Although platelet count is underestimated when the impedance method is used, the platelet count reveals similar results when measured by the fluorescent optical method.
Insights
Magnesium sulfate (MgSO4) offers a stable in vitro anticoagulant for platelet analysis, showing reliable mean platelet volume (MPV) measurements. While impedance methods may underestimate platelet counts, fluorescent optical methods provide accurate results with MgSO4.
Area of Science:
- Hematology
- Clinical Pathology
- Biochemistry
Background:
- Platelet count and mean platelet volume (MPV) measurements are crucial for diagnosing various hematological conditions.
- Existing anticoagulants like EDTA and citrate present challenges in maintaining platelet integrity and accurate measurements.
- Magnesium sulfate (MgSO4) is recognized for its anticoagulant properties, prompting investigation into its utility for platelet analysis.
Purpose of the Study:
- To evaluate magnesium sulfate (MgSO4) as an in vitro anticoagulant for platelet count, MPV, platelet distribution width, and platelet activation.
- To compare the reliability of MgSO4 with traditional anticoagulants (EDTA, citrate) for platelet parameter measurements.
- To assess the stability of platelet parameters in MgSO4-anticoagulated blood over time.
Main Methods:
- Whole blood samples from volunteers were collected and anticoagulated using EDTA, citrate, or MgSO4.
- Platelet counts and MPV were determined using the Sysmex XE 5000 analyzer, employing both impedance and fluorescence optical techniques.
- Platelet activation and cell swelling were also assessed in the different anticoagulant conditions.
Main Results:
- Magnesium sulfate (MgSO4) demonstrated stable platelet counts over 3 hours, unlike EDTA and citrate which showed variations.
- MPV measurements were consistently lower and potentially more reliable in MgSO4-anticoagulated samples compared to EDTA and citrate.
- EDTA samples exhibited significant platelet activation and cell swelling within 3 hours, which was minimal in MgSO4 samples.
Conclusions:
- Magnesium sulfate (MgSO4) shows promise as an anticoagulant for more accurate MPV measurements due to reduced platelet activation and cell swelling.
- For platelet count, while impedance methods may underestimate values with MgSO4, fluorescence optical methods yield comparable results to traditional anticoagulants.
- MgSO4 offers a stable and reliable alternative for in vitro platelet analysis, particularly for MPV assessment.
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