A case report of pseudo grey platelet syndrome with citrate-induced pseudothrombocytopenia: those artifacts may interfere in the platelet numeration and lead to critical misdiagnosis

Herb, Agathe; Maurer, Maxime; Alamome, Isabelle; Bihl, Pierre-Adrien; Ghiura, C.; Hurstel, Remy

doi:10.1684/abc.2017.1266

Cited by 1 publication

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“…The need for rapid analysis of an EDTA blood tube has been suggested by French guidelines [ 4 ] and others [ 10 ]. This is due to the time-dependent fall in PC, from 1 min after blood collection to 4 h afterwards [ 12 , 13 , 101 , 104 , 105 ]. Citrate-anticoagulated specimen also evidence underestimated PC when analyzed over 3 h after phlebotomy [ 106 ].…”

Section: Pre-analytical and Analytical Influencing Factorsmentioning

confidence: 99%

Pseudothrombocytopenia—A Review on Causes, Occurrence and Clinical Implications

Lardinois

Favresse

Châtelain

et al. 2021

JCM

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Pseudothrombocytopenia (PTCP), a relative common finding in clinical laboratories, can lead to diagnostic errors, overtreatment, and further (even invasive) unnecessary testing. Clinical consequences with potential life-threatening events (e.g., unnecessary platelet transfusion, inappropriate treatment including splenectomy or corticosteroids) are still observed when PTCP is not readily detected. The phenomenon is even more complex when occurring with different anticoagulants. In this review we present a case of multi-anticoagulant PTCP, where we studied different parameters including temperature, amikacin supplementation, measurement methods, and type of anticoagulant. Prevalence, clinical risk factors, pre-analytical and analytical factors, along with clinical implications, will be discussed. The detection of an anticoagulant-dependent PTCP does not necessarily imply the presence of specific disorders. Conversely, the incidence of PTCP seems higher in patients receiving low molecular weight heparin, during hospitalization, or in men aged 50 years or older. New analytical technologies, such as fluorescence or optical platelet counting, will be soon overturning traditional algorithms and represent valuable diagnostic aids. A practical laboratory approach, based on current knowledge of PTCP, is finally proposed for overcoming spuriously low platelet counts.

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