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PSEUDOTHROMBOCYTOPENIA
PSEUDOTHROMBOCYTOPENIA
A false diagnosis of thrombocytopenia can occur when laboratory conditions cause platelets to
clump, resulting in artificially low platelet counts as determined by automated counters. This
occurs in 0.1% to 0.2% of automated platelet counts. Occasionally, if a high proportion of
platelets are unusually large, the automated count can be spuriously low.
Blood films should always be carefully examined to confirm the presence of thrombocytopenia.
Laboratory Features
A film made from blood anticoagulated with EDTA demonstrates more platelets than expected
from the platelet count, but many are in large pools or clumps (see Figure 117-1 in Williams
Hematology, 9th ed). A blood film made directly from a fingerstick sample accurately reflects the
true count.
Pseudothrombocytopenia is often accompanied by a falsely elevated white count because some
platelet clumps are sufficiently large to be detected as leukocytes by an automated counter.
Correct platelet counts can be obtained by placing fingerstick blood directly into diluting fluid at
37°C and performing counts by phase-contrast microscopy.
Clinical Features
The platelet agglutinins causing spurious thrombocytopenia appear to have no other clinical
significance.
Platelet clumping is usually persistent.