تويت
EDTA induced Pseudo-thrombocytopaenia does simply mean false low platelets count given by analyzer which is due to platelets aggregation induced by EDTA anticoagulant.
[COLOR="Red"]When I suspect EDTA induced Pseudo thrombocytopaenia?
Whenever platelet count is low
What i need to do when i get low platelets count by the analyzer to confirm EDTA induced pseudo thrombocytopaenia?what i have to see?
Do peripheral blood smear and see if there is any platelets aggregation or clumps
In which category of people this phenomenon can be seen?
This phenomenon of EDTA-induced pseudothrombocytopenia has been reported rarely in both normal individuals and in association with a variety of diseases, such as infections with human immunodeficiency virus, rubella, and cytomegalovirus; autoimmune disorders; neoplastic diseases; thrombotic disorders; and possibly trauma. It occurs with an incidence of approximately 0.1% in the general population and has never been associated with hemorrhagic diathesis or platelet dysfunction.
Why does this occur?
this clumping is caused by an alteration of the platelet surface glycoproteins when they are incubated with a calcium chelator such as EDTA. These modified platelet antigens then react to anti-platelet autoantibodies (Immunoglobulins of both the IgG and IgM types) to form these large agglutinates
What advise should I give to the clinician in case if I found a case of EDTA pseudothrombocytopaenia?
Low platelets count is due to aggregation induced by EDTA, Kindly repeat with fresh Sodium Citrated anticoagulant sample in order to get actual platelet count.
References:
Bizzaro, N., et al. (1995). EDTA-Dependent Pseudothrombocytopenia: A Clinical and Epidemiological Study of 112 Cases, With 10-Year Follow-Up. American Journal of Hematology, 50, 103-109
Van der Meer, W., Allebes, W., Simon, A., van Berkel, Y., & de Keijzer, M. H. (2002). Pseudothrombocytopenia: A Report of a New Method to Count Platelets in a Person With EDTA- and Temperature-Independent Antibodies of the IgM Type. European Journal of Haematology, 69, 243-247.
Dalamangas, L. C., & Slaughter, T. F. (1998). Ethylenediaminetetraacetic Acid-Dependent Pseudothrombocytopenia in a Cardiac Patient. Anesth Analg, 86, 1210-1211.
Sakurai, S., Shiojima, I., Tanigawa, T., & Nakahara, K. (1997). Aminoglycosides prevent and dissociate the Aggregation of Platelets in Patients With EDTA-dependent Pseudothrombocytopenia. British Journal of Haematology, 99(4-II), 817-823.
Allerheiligen, D., Houston, R., & Vermedahl, B. (1996). EDTA-Induced Pseudothrombocytopenia. Jornal of the American Board of Family Practice, 9, 212-214.
Sweeney, J. D., Holme, W. L., Heaton, D. C., & Bowen, M. L. (1995). Pseudothrombocytopenia in Plateletpheresis Donors. Transfusion, 35, 46-49.
Mori, M., Kudo, H., Yoshitake, S., Ito, K., Shinguu, C., & Noguchi, T. (2000). Transient EDTA-Dependent Pseudothrombocytopenia in a Patient with Sepsis. Intensive Care Medicie, 26, 218-220.
Matarazzo, M., Conturso, V., Di Martino, M., Chiurazzi, F., Guida, G., & Morante, R. (2000). EDTA-Dependent Pseudothrombocytopenia in a case of Liver Cirrhosis. PANMINERVA MEDICA, 42, 155-157.
Ahn, H. L., et al. (2002). EDTA-Dependent Pseudothrombocytopenia Confirmed by Supplementation of Kanamycin; A Case Report. The Korean Journal of Internal Medicine, 17, 65-68.
Bartels, P., Schoorl, M., & Lombarts, A. (1997). Screening for EDTA-Dependent Deviations in Platelet Counts and Abnormalities in Platelet Distribution Histograms in Pseudothrombocytopenia. Scand J Clin Lab Invest, 57, 629-636.
Kabutomori, O., & Iwatani, Y. (1995). "Correct" Platelet Count in EDTA-Dependent Pseudothrombocytopenia. Eur J Haematol, 55, 67-68.
[COLOR="Red"]When I suspect EDTA induced Pseudo thrombocytopaenia?
Whenever platelet count is low
What i need to do when i get low platelets count by the analyzer to confirm EDTA induced pseudo thrombocytopaenia?what i have to see?
Do peripheral blood smear and see if there is any platelets aggregation or clumps
In which category of people this phenomenon can be seen?
This phenomenon of EDTA-induced pseudothrombocytopenia has been reported rarely in both normal individuals and in association with a variety of diseases, such as infections with human immunodeficiency virus, rubella, and cytomegalovirus; autoimmune disorders; neoplastic diseases; thrombotic disorders; and possibly trauma. It occurs with an incidence of approximately 0.1% in the general population and has never been associated with hemorrhagic diathesis or platelet dysfunction.
Why does this occur?
this clumping is caused by an alteration of the platelet surface glycoproteins when they are incubated with a calcium chelator such as EDTA. These modified platelet antigens then react to anti-platelet autoantibodies (Immunoglobulins of both the IgG and IgM types) to form these large agglutinates
What advise should I give to the clinician in case if I found a case of EDTA pseudothrombocytopaenia?
Low platelets count is due to aggregation induced by EDTA, Kindly repeat with fresh Sodium Citrated anticoagulant sample in order to get actual platelet count.
References:
Bizzaro, N., et al. (1995). EDTA-Dependent Pseudothrombocytopenia: A Clinical and Epidemiological Study of 112 Cases, With 10-Year Follow-Up. American Journal of Hematology, 50, 103-109
Van der Meer, W., Allebes, W., Simon, A., van Berkel, Y., & de Keijzer, M. H. (2002). Pseudothrombocytopenia: A Report of a New Method to Count Platelets in a Person With EDTA- and Temperature-Independent Antibodies of the IgM Type. European Journal of Haematology, 69, 243-247.
Dalamangas, L. C., & Slaughter, T. F. (1998). Ethylenediaminetetraacetic Acid-Dependent Pseudothrombocytopenia in a Cardiac Patient. Anesth Analg, 86, 1210-1211.
Sakurai, S., Shiojima, I., Tanigawa, T., & Nakahara, K. (1997). Aminoglycosides prevent and dissociate the Aggregation of Platelets in Patients With EDTA-dependent Pseudothrombocytopenia. British Journal of Haematology, 99(4-II), 817-823.
Allerheiligen, D., Houston, R., & Vermedahl, B. (1996). EDTA-Induced Pseudothrombocytopenia. Jornal of the American Board of Family Practice, 9, 212-214.
Sweeney, J. D., Holme, W. L., Heaton, D. C., & Bowen, M. L. (1995). Pseudothrombocytopenia in Plateletpheresis Donors. Transfusion, 35, 46-49.
Mori, M., Kudo, H., Yoshitake, S., Ito, K., Shinguu, C., & Noguchi, T. (2000). Transient EDTA-Dependent Pseudothrombocytopenia in a Patient with Sepsis. Intensive Care Medicie, 26, 218-220.
Matarazzo, M., Conturso, V., Di Martino, M., Chiurazzi, F., Guida, G., & Morante, R. (2000). EDTA-Dependent Pseudothrombocytopenia in a case of Liver Cirrhosis. PANMINERVA MEDICA, 42, 155-157.
Ahn, H. L., et al. (2002). EDTA-Dependent Pseudothrombocytopenia Confirmed by Supplementation of Kanamycin; A Case Report. The Korean Journal of Internal Medicine, 17, 65-68.
Bartels, P., Schoorl, M., & Lombarts, A. (1997). Screening for EDTA-Dependent Deviations in Platelet Counts and Abnormalities in Platelet Distribution Histograms in Pseudothrombocytopenia. Scand J Clin Lab Invest, 57, 629-636.
Kabutomori, O., & Iwatani, Y. (1995). "Correct" Platelet Count in EDTA-Dependent Pseudothrombocytopenia. Eur J Haematol, 55, 67-68.
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