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Analyzing Platelet Subpopulations by Multi-color Flow Cytometry

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Pseudothrombocytopenia with multiple anticoagulant sample collection tubes.

Ferenc Kovacs¹, Marina Varga², Zsolt Pataki³

¹Central Laboratory, Kanizsai Dorottya Hospital , Nagykanizsa, Hungary.

Interventional Medicine & Applied Science

|February 10, 2017

Summary

Pseudothrombocytopenia (PTCP) can affect platelet counts. This case highlights PTCP in an elderly patient, identified across multiple anticoagulant tubes except magnesium sulfate, a novel finding.

Keywords:

blood smear magnesium sulfate platelet aggregation pseudothrombocytopenia sample collection

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Area of Science:

Hematology
Clinical Pathology

Background:

Pseudothrombocytopenia (PTCP) is a pre-analytical condition affecting platelet count accuracy.
Accurate platelet (PLT) assessment is crucial for correct clinical diagnosis and treatment decisions.

Purpose of the Study:

To report a rare case of pseudothrombocytopenia (PTCP) in an elderly patient.
To investigate the effect of various anticoagulants on platelet count in a suspected PTCP case.

Main Methods:

A severe thrombocytopenia was detected in an elderly patient hospitalized for pneumonia.
Platelet counts were re-evaluated using different anticoagulant tubes: ethylenediaminetetraacetic acid, sodium citrate, lithium heparin, disodium oxalate, hirudin, and magnesium sulfate.
The patient presented with no clinical bleeding symptoms.

Main Results:

Severe thrombocytopenia (18 × 10^9/L) was initially observed in an ethylenediaminetetraacetic acid tube.
Platelet counts were consistently low across sodium citrate, lithium heparin, disodium oxalate, and hirudin tubes.
Platelet counts normalized only in the magnesium sulfate tube, indicating PTCP.
This is the first reported instance of PTCP involving five different anticoagulant sample collection tubes.

Conclusions:

Pseudothrombocytopenia can manifest differently depending on the anticoagulant used.
Magnesium sulfate appears to be a suitable anticoagulant for accurate platelet counting in this specific PTCP case.
Awareness of PTCP and its variable presentation is essential for laboratory professionals and clinicians.