Abstract

Background -Spurious thrombocytopenia or pseudothrombocytopenia (PTCP) is a well
known in vitro phenomenon that occurs when the anticoagulant used while testing the blood
samples causes clumping of platelets which results in spuriously low platelet count with
automated haematology analyser. It occurs most often in EDTA anticoagulated blood,
however other anticoagulants though to a lesser extent have also been implicated in several
reports. Clinical consequences include unnecessary platelet transfusions, bone marrow
aspiration and inappropriate treatment like administration of steroids.
Material and methods –This is a hospital based prospective study in department of clinical
pathology for one year duration from January 2021 to December 2021.
Results – A total of 82 were found to have EDTA induced pseudothrombocytopenia in the
study period. The total case load during the study period was 2581 cases. The incidence of
PTCP in our study being, 3.1%. Males accounted for 45% and females accounted for 55 %
with male to female ratio of 2.5: 3.
Mean platelet count in EDTA anticoagulated samples with PTCP was 39,333/mm3 mean
platelet count in sodium citrate sample was 1,78,666/mm3, and mean platelet count manually
was 2,10,552/mm3. Citrate anticoagulated samples showed higher values as compared to
EDTA.
Conclusion -EDTA-PTCP is a common pre analytical error encountered in routine clinical
laboratory practise. EDTA-PTCP should be suspected in all cases with a low platelet count
but without any clinical bleeding manifestations. Platelet counts should be reviewed in all
such cases to prevent unnecessary clinical interventions and treatment. Simple, inexpensive
and diagnostic method of peripheral smear examination remains gold standard.