COMPARISON OF ROLE OF ALTERNATIVE ANTICOAGULANT (MGSO4) IN EDTA-INDUCED PSEUDOTHROMBOCYTOPENIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 38
Abstract
BACKGROUND Pseudothrombocytopenia is a condition in which there is falsely low platelet in patients who have thrombocytopenia but no petechiae or ecchymoses or bleeding history. Prevalence of EDTA-dependent pseudothrombocytopenia ranging from 0.1-2% in hospitalised patients to 15-17% in outpatients is evaluated. Pseudothrombocytopenia is also an artifactual thrombocytopenia caused by anticoagulant dependent agglutinins. The reason for thrombocytopenia was EDTA-induced platelet aggregation. The aim of this study was to compare the platelet count in pseudothrombocytopenia in EDTA anticoagulated sample with other alternative anticoagulant (MgSO4). MATERIALS AND METHODS Blood sample was collected in a sterile EDTA containing tube and processed, our established laboratory then generated report of each patient. Informed consent was taken of all patients that took part in our study during repeat blood samples collected in MgSO4 anticoagulant for use of their samples for medical research, after physician’s request, investigated and generated the report. EDTA (Ethylenediaminetetraacetate) anti-coagulated whole blood samples for routine haematological analysis were selected for this study when suspicious for low platelet count. Both samples are run through the automated haematology analyser (three part differential, Mindray) and peripheral blood smear made for microscopic examination. RESULTS Study included 110 patients that shows EDTA-induced pseudothrombocytopenia, out of which 51 patients found raised platelet count >150×103/µL in MgSO4 anticoagulated blood sample. Mean platelet count in 110 patients in EDTA anticoagulated blood sample was 71.67 (67.08-76.26) ×103/µL and in MgSO4 anticoagulated blood sample was 153.63(44.96-169.84) ×103/µL. Mean platelet volume in 110 patients in EDTA blood sample was 11.45 fl (Range 11.09- 11.8) and in MgSO4 blood sample was 10.32 fl (range 9.3-11.3). Platelet count is low in EDTA blood sample in contrast to the sample anticoagulated with MgSO4. No significant correlation was found in other parameters of CBC, in blood samples anticoagulated with EDTA and MgSO4. In peripheral smear examination of EDTA-PTCP patients, 80% of patients showed platelet aggregation and clumping. CONCLUSION This study illustrates low platelet count in automated haematology analysers (Mindray) in EDTA blood sample. Peripheral blood smear should be examined for platelet clumping or aggregates in cases of low platelet count not correlating with clinical presentation or thrombocytopenia flagged in haematology analyser. Awareness of these patterns may alert to the presence of EDTA-PTCP in routine clinical practice. Alternative anticoagulant MgSO4 can be recommended for correct estimation of platelet count and to exclude EDTA-induced PTCP in order to prevent unnecessary surgical trouble and unwanted expenditure to the patient.
Authors and Affiliations
Hemlata Bamoriya, Mishra S. K, Sutrakar S. K, Ashutosh Garg, Kamlesh Sutrakar, Kali Gandhi
Keywords
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- EP ID EP212910
- DOI 10.14260/Jemds/2017/661
- Views 63
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