A case report of sudden thrombocytopenia detected only by in vitro analysis

Abstract

We experienced an unexpected thrombocytopenia detected only in vitro during radical prostatectomy for a 66-year-old patient. Thrombocytopenia with platelet aggregation was observed in a blood sample obtained using a heparinized syringe (not by ethylene diamine tetra-acetic acid tube). Although we could not exclude platelet agglutination in vivo, no thrombosis or coagulation disorder was observed. We changed the anti-coagulant in the arterial catheter carrier fluid (saline) from heparin to argatroban, and continued with the operation. No embolic complications were observed during the perioperative period. Although pseudothrombocytopenia or heparin-induced thrombocytopenia was highly suspected in the present case, we were not able to confirm which of the two developed. Multi-directional attention and care may be required for perioperative unexpected thrombocytopenia.

Thrombocytopaenia in Systemic Juvenile Idiopathic Arthritis: Not Always Macrophage Activation Syndrome!

“…2 Presence of normal platelet counts in the citrated and heparinized samples will confirm the fact that thrombocytopaenia is EDTA induced and not the real one. 3…”