Thrombocytopenia Vs Pseudo thrombocytopenia Will indices help us?

Abstract

Thrombocytopenia is defined as a platelet count of less than 1.5 lakhs/μL of anticoagulated blood. Platelet clumping is a common laboratory phenomenon resulting in pseudo thrombocytopenia that complicates platelet counts reporting. Some of the important causes are EDTA dependent agglutination and aggregation secondary to platelet activation, improper collection techniques, or delayed mixing with anticoagulants. Unfortunately, this pseudo thrombocytopenia is not well detected by the auto analyzers. In tropical countries like India, where dengue and malaria are endemic and important causes of thrombocytopenia, recognizing pseudo thrombocytopenia and minimizing the errors in platelet enumeration becomes vital. In this study, we compared various platelet indices between true thrombocytopenia and pseudo thrombocytopenia cases and found that only MPV is statistically significant. Hence, low platelet counts given by the automated hematology analyzer should be verified by a well stained peripheral smear and management should not go only by platelet parameters from the automated analyzer. This will prevent unnecessary referrals and platelet transfusions for the patient and thereby improve patient care.