In-Hospital Onset of Pseudothrombocytopenia Days before Surgery

Area of Science:

• Hematology
• Clinical Pathology
• Laboratory Medicine

Background:

• Automated cell counters are essential for routine blood analysis.
• Laboratory artifacts can compromise the accuracy of cell counts.
• Spurious thrombocytopenia (low platelet count) can result from various in vitro phenomena.

Observation:

• A case of platelet aggregation induced by a novel anticoagulant was identified.
• This aggregation was diagnosed during a preoperative assessment.
• The phenomenon mimicked true thrombocytopenia on automated cell counts.

Findings:

• The newly developed anticoagulant caused in vitro platelet aggregation.
• This aggregation led to spuriously low platelet counts.
• Diagnostic clues for this specific artifact were observed.

Implications:

• Erroneous low platelet counts can lead to inappropriate clinical decisions.
• Potential consequences include unnecessary platelet transfusions and delayed surgeries.
• Accurate diagnosis of artifactual thrombocytopenia is crucial for patient safety.