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Platelet Electron Microscopy: Utilizing LEAN Methodology to Optimize Laboratory Workflow.

Lucas Asher1, Jessica Hata1

  • 1Norton Children's Hospital, Louisville, Kentucky.

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
|May 20, 2020
PubMed
Summary

Platelet electron microscopy (PEM) can be optimized by reducing platelet counts. Whole mount preparations must be analyzed promptly to ensure accurate dense body (DB) counts for diagnosing storage pool disorders.

Keywords:
LEANdense granuleselectron microscopyplateletstorage pool disorderultrastructure

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Area of Science:

  • Hematology
  • Microscopy
  • Diagnostic Pathology

Background:

  • Platelet electron microscopy (PEM) is the gold standard for diagnosing storage pool disorders.
  • Limited literature and lack of standardization hinder PEM interlaboratory consistency.

Purpose of the Study:

  • To optimize PEM by reducing the number of platelets analyzed.
  • To establish standardized methods for accurate platelet morphology evaluation.

Main Methods:

  • Reviewed 300 pediatric whole mount (WM) cases for dense body (DB) counts.
  • Assessed DB counts on consecutive days for 6 cases.
  • Examined both WM and thin section (TS) preparations for all cases.

Main Results:

  • Developed a LEAN methodology algorithm to decrease platelet counts while maintaining accuracy.
  • Observed statistically significant decay in WM DB counts over time (p < .1).
  • 12 of 300 cases required both WM and TS for diagnosis.

Conclusions:

  • Accuracy can be maintained while decreasing platelet DB counts by over 75%.
  • Prompt analysis of WM is crucial to prevent false-negative results due to sample decay.
  • Accurate platelet morphology assessment necessitates both WM and TS techniques.