: further insights and recommendations for prevention of a clinically threatening artifact.
Even if this case may take place in the presence of huge blood platelets and their satellitosis, the most frequently seen factor is aggregation of thrombocyte (pseudothrombocytopenia
Review of a peripheral blood smear found no obvious evidence of pseudothrombocytopenia
. Serum ferritin was 53 ng/mL (reference interval: 20-275 ng/mL) and iron saturation was 18% (reference interval: 16%-48%).
 EDTA dependent pseudothrombocytopenia
is a rare phenomenon (i.e., around 0.1% in general population) which is mostly due to the presence of EDTA-dependent antiplatelet antibodies that react optimally between 0 [degrees]C to 4 [degrees]C, recognise the cytoadhesive receptors gpUb/IIIa, stimulate the expression of activation antigen, trigger activation of trypsin kinase, platelet agglutination and clumping in vitro.
Cases with pseudothrombocytopenia
due to platelet aggregation or platelet satellitism were excluded.
In evaluating a patient with thrombocytopenia, a key step is to review the peripheral blood smear and to first rule out "pseudothrombocytopenia
," particularly in a patient without an apparent cause for the thrombocytopenia.
In the differential diagnostic workup of APS-related thrombocytopenia one should always exclude, in addition to SLE, pseudothrombocytopenia
, TTP, DIC, and HIT and, when hemolytic anemia is present, Evans syndrome, a hematological condition reported to be associated with APS .
The mechanism of thrombocytopenia is poorly understood but shortened life span of platelets due to the immune mediated destruction of platelets by IgG antibodies directed against malarial antigen in platelet, elevated M-CSF level in malaria by increasing macrophage activity which induce platelet destruction, sequestration in spleen, increased cytokines, oxidative stress, and pseudothrombocytopenia
due to platelet clumps has been postulated.
Thrombocytopenia in cyanotic diseases is dangerous and it related to immune thrombocy topenia, polycythemia , hyperviscosity, pseudothrombocytopenia
, and drugs .
Platelet satellitosis occurs occasionally in peripheral blood samples collected in ethylenediaminetetraacetic acid anticoagulant and thus leads to pseudothrombocytopenia
. We examined 5 such cases, and Nextslide successfully detected platelet clumps in all cases (data not shown).
His platelet count is still low, but they say he has pseudothrombocytopenia
. He has never had any signs and symptoms and is really very healthy.
: a clinical study of 18 patients and a review of the literature.