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Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia
Automated hematology analyzer uses the Coulter principle leading to different cell types based on their size. Despite being rapid and convenient, it can result in spurious outcomes like ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia. EDTA-induced pseudothrombocytopenia is an i...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431305/ https://www.ncbi.nlm.nih.gov/pubmed/32821617 http://dx.doi.org/10.7759/cureus.9273 |
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author | Kharel, Himal Pokhrel, Nishan B Pant, Samriddha R Shrestha, Suraj Agrawal, Bishal |
author_facet | Kharel, Himal Pokhrel, Nishan B Pant, Samriddha R Shrestha, Suraj Agrawal, Bishal |
author_sort | Kharel, Himal |
collection | PubMed |
description | Automated hematology analyzer uses the Coulter principle leading to different cell types based on their size. Despite being rapid and convenient, it can result in spurious outcomes like ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia. EDTA-induced pseudothrombocytopenia is an immunologically mediated phenomenon resulting from a change in the configuration of glycoprotein (GP) IIb/IIIa by EDTA. The consequence is an exposure of hidden epitope that reacts with certain autoantibodies resulting in spuriously low platelet counts when the blood samples are evaluated by automated blood analyzers. Although it is a rare cause of thrombocytopenia, if not recognized, it can result in unnecessary investigations and treatments. In this case, EDTA-induced psuedothrombocytopenia delayed laparoscopic cholecystectomy planned for symptomatic cholelithiasis in a 58-year-old male. The presence of large platelet clumps on peripheral smear and normal manual platelet counts confirmed the diagnosis. Pseudothrombocytopenia should be suspected when there is no correlation between clinical and laboratory findings in a patient with a low platelet count. Reperforming counts with other anticoagulants and if necessary, manual count in the peripheral blood smear is suggested. |
format | Online Article Text |
id | pubmed-7431305 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-74313052020-08-18 Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia Kharel, Himal Pokhrel, Nishan B Pant, Samriddha R Shrestha, Suraj Agrawal, Bishal Cureus Internal Medicine Automated hematology analyzer uses the Coulter principle leading to different cell types based on their size. Despite being rapid and convenient, it can result in spurious outcomes like ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia. EDTA-induced pseudothrombocytopenia is an immunologically mediated phenomenon resulting from a change in the configuration of glycoprotein (GP) IIb/IIIa by EDTA. The consequence is an exposure of hidden epitope that reacts with certain autoantibodies resulting in spuriously low platelet counts when the blood samples are evaluated by automated blood analyzers. Although it is a rare cause of thrombocytopenia, if not recognized, it can result in unnecessary investigations and treatments. In this case, EDTA-induced psuedothrombocytopenia delayed laparoscopic cholecystectomy planned for symptomatic cholelithiasis in a 58-year-old male. The presence of large platelet clumps on peripheral smear and normal manual platelet counts confirmed the diagnosis. Pseudothrombocytopenia should be suspected when there is no correlation between clinical and laboratory findings in a patient with a low platelet count. Reperforming counts with other anticoagulants and if necessary, manual count in the peripheral blood smear is suggested. Cureus 2020-07-19 /pmc/articles/PMC7431305/ /pubmed/32821617 http://dx.doi.org/10.7759/cureus.9273 Text en Copyright © 2020, Kharel et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Kharel, Himal Pokhrel, Nishan B Pant, Samriddha R Shrestha, Suraj Agrawal, Bishal Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia |
title | Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia |
title_full | Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia |
title_fullStr | Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia |
title_full_unstemmed | Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia |
title_short | Surgical Delay due to Ethylenediaminetetraacetic Acid-Induced Pseudothrombocytopenia |
title_sort | surgical delay due to ethylenediaminetetraacetic acid-induced pseudothrombocytopenia |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431305/ https://www.ncbi.nlm.nih.gov/pubmed/32821617 http://dx.doi.org/10.7759/cureus.9273 |
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