Pseudothrombocytopenia induced by EDTA and chronic inflammatory demyelinating polyneuropathy
DOI:
https://doi.org/10.51481/amc.v58i2.925Keywords:
Thrombocytopenia, EDTAAbstract
Ethylenediaminetetraacetic acid is an anticoagulant widely used in health sciences in the processing of medical samples. Given that, in the presence of certain immune conditions, this agent can induce a false low platelet count (pseudothrombocytopenia), it must be considered as part of the differential diagnosis for thrombocytopenia. The case presented is about a 68 year old patient with severe thrombocytopenia with no clinical evidence of bleeding, which was later demonstrated as pseudothrombocytopenia induced by EDTA. The presence of a false thrombocytopenia was demonstrated adding amikacin to the blood sample.
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References
Gowland E, Kay HE, Spillman JC, Williamson JR. Agglutination of platelet by a serum factor in the presence of EDTA. J Clin Pathol 1969; 22: 460-64.
Watkins SP, Shulman NR. Platelet cold agglutinins. Blood 1970; 36: 153-58.
Gordan HG, Larson NL. Use of sequestrene as an anticoagulant. Am J Clin Pathol. 1955; 23: 613-18.
Berkman N, Michaeli Y, Or R, Eldor A. EDTA-dependent pseudothrombocytopenia: A clinical study of 1 8 patients and a review of the literature. Am J Hematol 1991; 36:195.
Bizarro N. EDTA-dependent pseudothrombocytopenia: a clinical and epidemiological study of 112 cases, with 10-year follow-up. Am J Hematol 1995; 50: 103-109.
Bartels PC, Schoorl M, Lombarts AJ. Screening for EDTA-dependent deviations in platelet counts and abnormalities in platelet distribution histograms in pseudothrombocytopenia. Scand J Clin Lab Invest 1997; 57: 629-636.
Vicari A, Banfi G, Bonini PA: EDTA-dependent pseudothrombocytopaenia: a 12-month epidemiological study. Scand J Clin Lab Invest 1988; 48: 537-542.
Zandecki M, Genevieve F, Gerard J, Godon A: Spurious counts and spurious results on haematology analysers: a review. Part I: platelets. Int J Lab Hematol 2007; 29: 4-20.
Onder O, Weinstein A, Hoyer LW. Pseudothrombocytopenia caused by platelet agglutinins that are reactive in blood anticoagulated with chelating agents. Blood 1980; 56: 177-182.
Pegels JG, Bruynes ECE, Engelfriet CP, von dem Borne AEG. Pseudothrombocytopenia: Animmunologic study on platelet antibodies dependent on ethylene diamine tetraacetate. Blood 1982; 59: 157-161.
Hoyt RH, Durie BGM. Pseudothrombocytopenia induced by a monoclonal IgM kappa platelet agglutinin. Am J Hematol 1989; 31: 50-52.
Ryo R, Sugano W, Goto M, et al. Platelet release reaction during EDTA induced platelet agglutinations and inhibition of EDTA-induced platelet agglutination by anti-glycoprotein Ilb/IIIa complex monoclonal antibody. Thromb Res 1994; 74: 265-272
Imai H, Nakamoto Y, Miki K, Miyakuni T, Miura AB. Pseudothrombocytopenia and IgA-related platelet agglutinin in a patient with IgA nephritis. Nephron 1983; 34: 154-158.
Ohashi-Fukuda N, Inokuchi R, Sato H, Nakamura K, Iwagami M, Wada T, et al. Poorer prognosis with ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia: a single-center case-control study. Medicine (Baltimore). 2015; 94:e674.
Ohnuma O, Shirata Y, Miyazawa K. Use of theophylline in the investigation of Pseudo-Thrombocytopenia induced by EDTA. J Clin Pathol. 1988;41:915-17.
Sakurai S, Shiojima I, Tanigawa T, Nakahara K. Aminoglycosides prevent and dissociate the aggregation of platelets in patients with EDTA-dependent pseudothrombocytopenia. Br J Haematol 1997; 99: 817-823.
Hyojin Chae, Myungshin Kim, Jihyang Lim, Eun-Jee Oh, Yonggoo Kim and Kyungja Han. Novel method to dissociate platelet clumps in EDTA-dependent pseudothrombocytopenia based on the pathophysiological mechanism. Clin Chem Lab Med 2012;50: 1387-1391.
Lippi G, Plebani M. EDTA-dependent pseudothrombocytopenia: further insights and recommendations for prevention of a clinically threatening artifact. Clin Chem Lab Med 2012; 50:1281-1285.
Zhou X, Wu X, Deng W, Li J, Luo W. Amikacin Can Be Added to Blood to Reduce the Fall in Platelet Count. Am J Clin Pathol 2011; 136: 646-652.
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