Ineffective communication equals no communication: a case report of splenic hyperfunction combined with...

Thrombocytopenia may be caused by diseases of various organ systems, especially the blood system. Certain drugs may also cause thrombocytopenia. In addition, it can result from various causes of pseudo-reduction. Therefore, a correct understanding of the causes of thrombocytopenia and their underlying mechanisms has important significance for clinical diagnosis and treatment. This study aimed to report a case of a 68-year-old woman with left upper abdominal mass and loss of appetite. The auxiliary examination showed splenomegaly and thrombocytopenia. The clinician planned to perform splenectomy. However, the laboratory physician considered that thrombocytopenia might be ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia (EDTA-PTCP). After effective communication between laboratory physicians and clinicians, the patient was diagnosed with splenic hyperfunction and pseudothrombocytopenia, and finally saved from undergoing splenectomy. The patient has a good prognosis after oral medication. Thrombocytopenia in this patient is caused by both hypersplenism and EDTA antagonism which is different from a single factor in other reports. The diagnosis of hematological abnormality may be challenging for physicians, especially thrombocytopenia. Therefore, medical staff should possess a rigorous working style and a high sense of responsibility besides maintaining high professional quality. Further, they should actively, timely, and effectively communicate with auxiliary departments to avoid misdiagnosis and missed diagnosis.