Diagnostic role of platelet indices and leukocyte count in pseudothrombocytopenia

Öz

Pseudothrombocytopenia, immune thrombocytopenia, diagnosis, complete blood count indices

Anahtar Kelimeler

• Pseudothrombocytopenia
• immune thrombocytopenia
• diagnosis
• complete blood count indices

Diagnostic role of platelet indices and leukocyte count in pseudothrombocytopenia

Öz

Objective: This study aimed to evaluate whether platelet indices and leukocyte count predict the diagnosis of Ethylene Diamine Tetra Acetic Acid induced pseudothrombocytopenia (EDTA-PTCP) and differ this entity from immune thrombocytopenia (ITP). Methods: One-hundred and sixty-nine individuals (52 patients diagnosed with EDTA-PTCP, 52 patients with newly diagnosed ITP, and 65 healthy individuals) were included. Demographic data and complete blood count (CBC) indices were compared between groups retrospectively. Results: Age and sex distribution were similar in all groups. Between EDTA-PTCP and ITP groups, no difference was found for absolute leukocyte, neutrophil, lymphocyte, and monocyte counts as well as hemoglobin level, red-cell distribution width (RDW), and platelet distribution width (PDW). The median mean platelet volume (MPV) of the ITP group was found to be higher than the control and EDTA-PTCP groups (p<0.001 and p=0.001, respectively, 95% confidence interval; 2.52-4.45 and 0.56-2.6). Conclusion: The results support that low platelet count in CBC may be a false result due to EDTA. Thrombocytopenic patients who have no bleeding symptoms and with normal MPV should be evaluated for EDTA-PTCP. This evaluation can be made by a peripheral blood smear or CBC in a blood tube containing other anticoagulants than EDTA (such as citrate or heparin). Therefore the increase in MPV may indicate a diagnosis of ITP rather than EDTA-PTCP. To make a more definite recommendation on this issue, studies involving more patients are needed.

Anahtar Kelimeler

• Pseudothrombocytopenia
• immune thrombocytopenia
• diagnosis
• complete blood count indices

Kaynakça

1. 1. Jali AGP, Nkambule BB. Prevalence and etiology of moderate and severe thrombocytopenia in a tertiary and quaternary centre in KwaZulu-Natal. Afr J Lab Med. 2020;9(1):799. doi: 10.4102/ajlm.v9i1.799
2. 2. Hillman RS, Ault KA, Leporrier M, Rinder HM. Thrombocytopenia. Hematology in Clinical Practice, 5e. New York, NY: McGraw-Hill Medical; 2016.
3. 3. Berkman N, Michaeli Y, Or R, Eldor A. EDTA-dependent pseudothrombocytopenia: a clinical study of 18 patients and a review of the literature. Am J Hematol. 1991;36(3):195-201. doi: 10.1002/ajh.2830360307
4. 4. Lin J, Luo Y, Yao S, Yan M, Li J, Ouyang W, et al. Discovery and correction of spurious low platelet counts due to EDTA‐dependent pseudothrombocytopenia. J Clin Lab Anal. 2015;29(5):419-26. doi: 10.1002/jcla.21818
5. 5. Lau LG, Chng WJJT. Unnecessary transfusions due to pseudothrombocytopenia: Transfusion medicine illustrated. Transfusion. 2004;44(6):801. doi: 10.1111/j.1537-2995.2004.04009.x