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Aminoglycosides prevent and dissociate the aggregation of platelets in patients with EDTA-dependent
S Sakurai1, I Shiojima, T Tanigawa
1Department of Central Laboratory, Tokyo University Hospital, Japan.
Abstract:
Although EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is of practical importance because failure to recognize this clinical entity may result in misdiagnosis and subsequent mismanagement of the patients, the pathophysiological nature of EDTA-PTCP remains unknown. To develop an effective way to evaluate the platelet counts in patients with EDTA-PTCP, we introduced aminoglycosides-supplemented anticoagulating agents. When kanamycin was pre-supplemented with EDTA for anticoagulating blood samples from EDTA-PTCP patients there was no significant change in the platelet counts and the morphology of blood cells after 150 min of incubation at room temperature. Furthermore, when kanamycin was added to EDTA-anticoagulated blood samples from EDTA-PTCP patients within 30 min after blood withdrawal, rapid dissociation of platelets without apparent morphological changes of blood cells was observed, and complete blood cell counts as well as the histogram patterns were almost the same as those examined immediately after blood sampling. The dissociation of aggregated platelets was also detected when other antibiotics were used, although it was associated with some extent of morphological changes of blood cells. These findings indicate that the supplementation of aminoglycosides either before or after blood sampling is a useful method for the diagnosis EDTA-PTCP and for the evaluation of platelet counts in patients with EDTA-PTCP.
Insights
Aminoglycosides effectively prevent platelet clumping in EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) samples. This method aids accurate platelet counts and diagnosis of EDTA-PTCP, improving patient management.
Area of Science:
- Hematology
- Clinical Pathology
- Laboratory Medicine
Background:
- EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is a common in vitro phenomenon.
- Failure to recognize EDTA-PTCP can lead to misdiagnosis and improper patient treatment.
- The underlying pathophysiology of EDTA-PTCP is not fully understood.
Purpose of the Study:
- To develop a reliable method for accurate platelet count evaluation in EDTA-PTCP patients.
- To investigate the efficacy of aminoglycoside-supplemented anticoagulants for EDTA-PTCP diagnosis.
Main Methods:
- Blood samples from EDTA-PTCP patients were anticoagulated with EDTA supplemented with kanamycin.
- Kanamycin was added either before sample collection or within 30 minutes post-collection.
- Platelet counts and cell morphology were analyzed after incubation.
Main Results:
- Pre-supplementation with kanamycin and EDTA did not alter platelet counts or cell morphology after 150 minutes.
- Adding kanamycin to EDTA-anticoagulated samples within 30 minutes caused rapid platelet dissociation without significant cell changes.
- Other antibiotics also dissociated platelets but caused some morphological alterations.
Conclusions:
- Aminoglycoside supplementation is a practical method for diagnosing EDTA-PTCP.
- This approach enables accurate platelet count evaluation in patients with EDTA-PTCP.
- The findings facilitate improved diagnostic accuracy and patient management for EDTA-PTCP.