Pappenheimer bodies. An additional cause for a spurious platelet count

Area of Science:

• Hematology
• Clinical Pathology
• Anemia Research

Background:

• Sideroblastic anemia is a group of disorders characterized by anemia and the presence of ring sideroblasts in the bone marrow.
• Accurate platelet counts are essential for diagnosing and managing various hematological conditions.
• Electrooptical instruments are commonly used for automated blood cell counting.

Observation:

• A 67-year-old woman with sideroblastic anemia presented with a spuriously elevated platelet count.
• The elevated platelet count was primarily attributed to the presence of Pappenheimer bodies.
• Automated electrooptical methods yielded a falsely high platelet count.

Findings:

• Phase microscopy and peripheral blood smear analysis confirmed the true platelet count.
• Pappenheimer bodies, iron inclusions in red blood cells and platelets, were identified as the cause of the artifactual elevation.
• This represents a previously unreported cause of spuriously elevated platelet counts.

Implications:

• Highlights the importance of microscopic review in cases of discrepant automated blood counts.
• Underscores the need to consider Pappenheimer bodies as a potential cause of pseudothrombocytosis.
• Contributes to the understanding of diagnostic challenges in hematological disorders.