A CASE OF EDTA-DEPENDENT PSEUDOTHROMBOCYTOPENIA IN A PATIENTREFERRED TO SURGICAL VALVE REPLACEMENT

Abstract

EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is a common in vitro phenomenon with prevalence rate ranging from 0.1-2% among hospitalised patients to 15-17% among outpatients evaluated for isolated thrombocytopenia [1]. It is reported both in healthy individuals and in patients with various diseases, including collagen vascular diseases and neoplasms [2]. Understanding the pathophysiology aspects of EDTA-PTCP and early detection of the condition are crucial for both the patient and the treating physician. Diagnostic clarification involves evaluating the instrument cell histograms and visualising platelet agglutinates in blood smears with EDTA anticoagulant. The recommendation to repeat the platelet count in a new blood collection by using alternative anticoagulant, prevents clinical consequences with potential life-threatening conditions – unnecessary transfusion of platelets, inappropriate high doses of corticosteroids, even splenectomy. This report outlines a clinical case of EDTA-PTCP in which significant differences in platelet counts were observed between hematology analyzers (Sysmex XN-1000, Sysmex XN-350) of blood samples in EDTA vacutainer and a S-Monovette® ThromboExact tubes containing magnesium sulfate. The purpose of this presentation is to focus on the successful and timely detection of the EDTA-PTCP phenomenon in laboratory practice, which plays an essential role in making correct therapeutic decisions and leads to successfully performed surgical interventions and improvement of the patient’s quality of life.