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Estimation of Platelet Counts and Other Hematological Parameters in Pseudothrombocytopenia Using Alternative
Chidambharam Choccalingam1, Rajesh Kanna Nandagopal Radha1, Nadella Snigdha1
1Department of Pathology, Chettinad Medical College, Kelambakkam, India.
Abstract:
The platelet count, mean platelet volume, and other hematological parameters were compared in blood samples anticoagulated with MgSO4 and EDTA. A total of 15 samples were taken, and the platelet counts were observed to be significantly high in MgSO4-anticoagulated blood samples ranging from 53 × 103 to 499 × 103/μL, whereas in EDTA-anticoagulated blood samples, the counts ranged from 10 × 103 to 353 × 103/μL. This increased platelet count was also statistically significant with the P value being .005. The morphology of red blood cells and white blood cells in Leishman-stained smears from MgSO4-anticoagulated blood was below average. In conclusion, MgSO4 can be used as an alternative anticoagulant only to estimate the platelet counts in EDTA-induced pseudothrombocytopenia.
Insights
Magnesium sulfate (MgSO4) can be an alternative anticoagulant for estimating platelet counts, particularly in cases of EDTA-induced pseudothrombocytopenia. However, it affects red and white blood cell morphology.
Area of Science:
- Hematology
- Clinical Pathology
- Biochemistry
Background:
- Accurate platelet counting is crucial for diagnosing and managing various hematological conditions.
- Ethylenediaminetetraacetic acid (EDTA) is a common anticoagulant, but it can induce pseudothrombocytopenia, leading to inaccurate platelet counts.
- Alternative anticoagulants are needed to overcome EDTA-induced artifacts in platelet estimations.
Purpose of the Study:
- To compare the efficacy of magnesium sulfate (MgSO4) as an anticoagulant versus EDTA for platelet count determination.
- To assess the impact of MgSO4 on other hematological parameters, including red blood cell (RBC) and white blood cell (WBC) morphology.
Main Methods:
- Blood samples from 15 participants were collected and anticoagulated using both MgSO4 and EDTA.
- Platelet counts were measured in both types of anticoagulated samples.
- Morphological examination of RBCs and WBCs was performed on Leishman-stained smears from MgSO4-anticoagulated blood.
Main Results:
- Platelet counts were significantly higher in MgSO4-anticoagulated samples (53–499 × 10^3/μL) compared to EDTA-anticoagulated samples (10–353 × 10^3/μL).
- The difference in platelet counts between MgSO4 and EDTA was statistically significant (P = .005).
- The morphology of RBCs and WBCs in MgSO4-anticoagulated blood smears was observed to be below average.
Conclusions:
- Magnesium sulfate (MgSO4) can serve as a viable alternative anticoagulant for accurately estimating platelet counts, especially in cases of EDTA-induced pseudothrombocytopenia.
- Clinicians should be aware that MgSO4 may affect the morphology of red and white blood cells, potentially impacting differential counts or morphological assessments.
- Further research is warranted to fully elucidate the effects of MgSO4 on comprehensive hematological profiling.

