EDTA‑dependent pseudothrombocytopenia in child (clinical case report)

2021 ◽  
pp. 51-54
Author(s):  
N. A. Sokolova ◽  
M. I. Savina ◽  
O. S. Shokhina
Keyword(s):  
Platelet Count ◽  
Clinical Case ◽  
Sodium Citrate ◽  
Ethylenediaminetetraacetic Acid ◽  
Hemorrhagic Diathesis ◽  
Platelet Dysfunction ◽  
Rare Presentation ◽  
Blood Samples ◽  
Low Platelet Count ◽  
Aggregation Of Platelets

Ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia is the phenomenon of a spurious low platelet count due to antiplatelet antibodies that cause platelet clumping in blood anticoagulated with EDTA. The aggregation of platelets in EDTA-dependent pseudothrombocytopenia is usually prevented by other anticoagulants, such as sodium citrate. EDTA-dependent pseudothrombocytopenia has never been associated with hemorrhagic diathesis or platelet dysfunction. In this article, a 2,5-year-old boy with EDTA-dependent pseudothrombocytopenia is presented because of rare presentation. We report that EDTA can induce platelet clumping, and thus spuriously low platelet counts. However, aggregation of platelets was not detected in blood samples with sodium citrate, and platelet count was normal.

scholarly journals Pseudothrombocytopenia: early recognition avoids unnecessary intervention

2020 ◽  
Vol 7 (10) ◽  
pp. 2058
Author(s):  
Rajeshwari Narayanan ◽  
Prahada Jagannathan ◽  
Kala Kandhasamy
Keyword(s):  
Sodium Citrate ◽  
Ethylenediaminetetraacetic Acid ◽  
Early Recognition ◽  
Diagnostic Testing ◽  
Febrile Illness ◽  
Girl Child ◽  
Low Platelet Count ◽  
Induced Aggregation ◽  
Aggregation Of Platelets ◽  
Unnecessary Intervention

Ethylenediaminetetraacetic acid dependent pseudothrombocytopenia (EDTA-PTCP) is the phenomenon of a spurious low platelet count due to EDTA induced aggregation of platelets. Failure to identify this can lead to unwarranted diagnostic testing, platelet transfusions and deferring emergency surgeries. An adolescent girl child was referred for acute febrile illness with thrombocytopenia. Peripheral smear examination of EDTA sample revealed platelet clumping. WBC and platelet histograms also supported the same. Repeat platelet counts in sodium citrate and heparin confirmed EDTA-PTCP.

1-Desamino-8-D-Arginine Vasopressin (DDAVP) Infusion in Type IIB von Willebrand’s Disease: Shortening of Bleeding Time and Induction of a Variable Pseudothrombocytopenia

1990 ◽  
Vol 64 (01) ◽  
pp. 117-120 ◽  
Author(s):  
Alessandra Casonato ◽  
M Teresa Sartori ◽  
Luigi de Marco ◽  
Antonio Girolami
Keyword(s):  
Monoclonal Antibody ◽  
Platelet Count ◽  
Arginine Vasopressin ◽  
Calcium Concentration ◽  
Sodium Citrate ◽  
Bleeding Time ◽  
Blood Collection ◽  
Von Willebrand's Disease ◽  
Blood Samples ◽  
Von Willebrand’S Disease

SummaryWe have investigated the effects of 1-desamino-8-D-arginine vasopressin (DDAVP) infusion on platelet count and bleeding time in 4 patients with type IIB von Willebrand’s disease (vWd). Three of four patients showed a normalization of the bleeding time within 1 h after the infusion, while bleeding time was not modified in the fourth. In accordance with the literature, thrombocytopenia was observed after DDAVP infusion, but this thrombocytopenia was due to the anticoagulants used for blood collection. In two patients (F. I., G. F.) no thrombocytopenia was observed when platelets were counted by fingerstick method but there was a 20% platelet decrease in blood samples collected in sodium citrate and a 50% decrease in samples collected in EDTA. Dramatic falls in platelet counts (70–95%) were observed in the additional two patients (C. A., D.Z.) after DDAVP infusion, when both sodium citrate or EDTA were used as anticoagulants. In the latter two patients there was also a 50% decrease in platelet count when the fingerstick method was used. The decrease in the patient’s platelet count in EDTA samples after DDAVP infusion could be prevented, in part, by the previous additions of an anti GPIb monoclonal antibody and an anti GPIIb-IIIa monoclonal antibody.Thus, the thrombocytopenia observed in the four IIB vWd patients studied after DDAVP infusion seems to be, at least partially, a pseudothrombocytopenia depending on the calcium concentration in the blood samples and the availability of GPIb and GPIIb-IIIa receptors. These findings and the normalization of the bleeding time observed in three of the four patients has led us to reconsider the possible use of DDAVP in the treatment of our IIB vWd patients.

scholarly journals Ethylenediaminetetraacetic Acid‑Dependent Pseudothrombocytopenia in Patient Previously Treated as Dengue Fever

2021 ◽  
Vol 17 (1) ◽  
pp. 65
Author(s):  
Hendra Wana Nur’amin ◽  
Muhammad Darwin Prenggono ◽  
Wivina Riza Devi
Keyword(s):  
Bone Marrow ◽  
Platelet Count ◽  
Dengue Fever ◽  
Complete Blood Count ◽  
Ethylenediaminetetraacetic Acid ◽  
Bone Marrow Aspiration ◽  
Normal Platelet ◽  
Low Platelet Count ◽  
Bleeding Manifestation ◽  
Secondary Hospital

Abstract: One of the most widely used anticoagulants for a complete blood count is ethylenediaminetetraacetic acid (EDTA).  Pseudothrombocytopenia (PTCP) may be caused by EDTA, this condition may lead to inappropriate diagnosis and treatment. We report a 25-year-old female with unspecific headache and joint pain with very low platelet count since 1 month before hospital admission. She was diagnosed with Dengue fever infection and got some platelet transfusion from the previous secondary hospital. She was carried out for a blood test with another anticoagulant (sodium citrate) and bone marrow aspiration. The results showed that she had normal platelet count and bone marrow cellularity. When a patient was identified with thrombocytopenia without any bleeding manifestation, hematology disease, and family history, PTCP should be taken into consideration to prevent unnecessary intervention. Keywords: platelet, pseudothrombocytopenia, ethylenediaminetetraacetic acid, Dengue fever

Comparison of the influence of EDTA-K3 and sodium citrate on haematology analysis in healthy dogs

2012 ◽  
Vol 15 (2) ◽  
pp. 391-392 ◽  
Author(s):  
M. Żmigrodzka ◽  
A. Winnicka ◽  
M. Guzera
Keyword(s):  
Platelet Count ◽  
Sodium Citrate ◽  
Ethylenediaminetetraacetic Acid ◽  
Haemoglobin Concentration ◽  
Healthy Dogs ◽  
Citrate Blood

Comparison of the influence of EDTA-K3 and sodium citrate on haematology analysis in healthy dogs The study was carried out on 30 clinically healthy dogs of various breeds. Haemoglobin concentration, haematocrit, platelet count and platelet haematocrit were significantly lower in citrate blood than in tripotassium ethylenediaminetetraacetic acid (EDTA-K3) blood. The study confirmed the limited usage of sodium citrate in haematology analysis, unless canine EDTA-dependent thrombocytopenia is suspected.

Pseudothrombocytopenia Secondary to the Effects of EDTA in a Dog

2008 ◽  
Vol 44 (2) ◽  
pp. 95-97 ◽  
Author(s):  
Tamara B. Wills ◽  
K. Jane Wardrop
Keyword(s):  
Platelet Count ◽  
Sodium Citrate ◽  
Ethylenediaminetetraacetic Acid ◽  
Pathological Process ◽  
Bleeding Tendency ◽  
Medical Treatments ◽  
Hematology Analyzer ◽  
Clinically Significant

Pseudothrombocytopenia (PTCP) secondary to the effects of ethylenediaminetetraacetic acid (EDTA) has been noted in horses and pigs and should be considered in dogs with moderate thrombocytopenia and no clinical bleeding tendency. This type of pseudothrombocytopenia is not a pathological process by itself, but it can be clinically significant if diagnostics and medical treatments are initiated based on the reported thrombocytopenia. Platelet clumping occurs with EDTA-dependent PTCP, resulting in inaccurate hematology analyzer platelet concentrations. A nontraumatic venipuncture may be sufficient to obtain an accurate platelet count. However, rare cases in the dog may require blood drawn into a different anticoagulant, such as sodium citrate, to help discriminate a true thrombocytopenia from PTCP.

scholarly journals A pediatric case of EDTA-related pseudothrombocytopenia and implementation of the histograms by the automated cell counters

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
F. Sinem Hocaoglu-Emre ◽  
Berna Yavuz Aksu
Keyword(s):  
Platelet Count ◽  
Case Report ◽  
Platelet Aggregation ◽  
Ethylenediaminetetraacetic Acid ◽  
Pediatric Case ◽  
Case Presentation ◽  
Low Platelet Count ◽  
Cell Counter ◽  
Persistent Thrombocytopenia

Abstract Objectives Platelet aggregation in the presence of ethylenediaminetetraacetic acid (EDTA), is called EDTA-related pseudothrombocytopenia (EDTA-PTP), resulting in low platelet count by automatic cell counters. Case presentation Herein, we present a case of a 5-year-old female, who was referred to our laboratory due to persistent thrombocytopenia. Conclusion Our case report discusses the efficiency of the histograms and flag warnings of the cell counter, indicating the importance of these variables.

Ultrastructural morphometric investigations on human platelets

1978 ◽  
Vol 36 (2) ◽  
pp. 456-457
Author(s):  
H. Themann ◽  
K. Stahl ◽  
W.R. Dame
Keyword(s):  
Platelet Count ◽  
Fine Structure ◽  
Drug Use ◽  
Sodium Citrate ◽  
Normal Values ◽  
Human Platelets ◽  
Needle Puncture ◽  
Blood Samples ◽  
History Of ◽  
Healthy Females

Qualitative fine-structure examinations of human platelets have been carried out by a number of investigators (see for example WHITE (1972) and references in his report). It is the purpose of this report to characterize the normal values of morphometric variables occurring in human platelets.Materials and MethodsPlatelets were obtained from clinically healthy females with ages ranging from 18-32, all of whom had documented normal hematological findings (normal differential, platelet count, PT, PTT, and fibrinogen values) and no history of drug use for at least 2 months. All blood samples (one per donor) were obtained by large-bore (1.5 mm) needle puncture of the medial antecubital vein. Samples were treated in one of the following two ways:(1)after disposal of the first ml, 9 ml were slowly drawn into a syringe containing 1 ml of 3.8% sodium citrate. Samples were then immediately centrifuged at 1000 x g for 1.5 min at 23°C.

scholarly journals An unusual case of sodium citrate-dependent artifactual platelet count

2020 ◽  
Vol 11 (3) ◽  
pp. 193-196
Author(s):  
Francesco Dima ◽  
Gian Luca Salvagno ◽  
Elisa Danese ◽  
Dino Veneri ◽  
Giuseppe Lippi
Keyword(s):  
Platelet Count ◽  
Case Report ◽  
Sodium Citrate ◽  
Ethylenediaminetetraacetic Acid ◽  
Healthy Woman ◽  
Mild Anemia ◽  
Essentially Normal ◽  
Blood Smears ◽  
Platelet Aggregates ◽  
Sample Dilution

Background Ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia is a rare phenomenon. Spurious pseudothrombocytopenia has also been described in other circumstances, while artifactual platelet count in whole blood samples anticoagulated with sodium citrate is an exceptional occurrence. Case report In this study, we describe the case of a 44-year-old ostensibly healthy woman who attended the local outpatient clinic for routine laboratory testing, including platelet count in EDTA and sodium citrate, for suspected artifactual pseudothrombocytopenia previously identified in another center. The results of hematological testing on both specimens were essentially normal, except for mild anemia. Nevertheless, the platelet number was 425 × 109/L in K2EDTA and 266 × 109/L (293 × 109/L after correcting for sample dilution) in sodium citrate, respectively. Microscopic revision of blood smears revealed the presence of platelet aggregates and satellitism only in the sodium citrate specimen. Conclusion Unlike previous occasional reports of concomitant EDTA- and sodium citrate-dependent pseudothrombocytopenia, we first describe a paradigmatic case of artifactual platelet count attributable to platelet clumping and satellitism, exclusively developing in blood anticoagulated with sodium citrate.

scholarly journals Pseudo-thrombocytopenia (PTCP). A challenge in the daily laboratory routine?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Peter Schuff-Werner ◽  
Joe Mansour ◽  
Angela Gropp
Keyword(s):  
Platelet Count ◽  
Ethylenediaminetetraacetic Acid ◽  
Cell Counting ◽  
Routine Laboratory ◽  
Temperature Dependent ◽  
Actual Knowledge ◽  
Blood Cell Counting ◽  
Aggregation Of Platelets

AbstractAnticoagulation with Ethylenediaminetetraacetic acid (EDTA) is a necessary pre-requisite for automated blood cell counting. With a prevalence of 0.01–1%, EDTA anticoagulation is accompanied by time- and temperature-dependent in vitro aggregation of platelets, resulting in false low counts. To avoid wrong clinical conclusions, spontaneous anticoagulant-induced platelet agglutination should therefore be recognized during analysis. This might be a challenge for the routine laboratory.The actual knowledge of this rare but clinically important laboratory artefact will be summarized and reviewed in the following, based on our own experiences and the available literature. This includes pathophysiological and epidemiological aspects, valuable information regarding the detection and prevention of a PTCP, and the possibilities for determination of the correct platelet count.

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