Pseudothrombocytopenia

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Abstract
Summary Three cases of a false low platelet count due to Platelet clumping in the presence of ethylenediamine tetraacetate (EDTA) are reported. In the first two cases a low platelet count was found in a preoperative coagulation screening in the absence of a bleeding diathesis and with a normal bleeding time. In the third patient low Platelet counts were repeatedly found in EDTA anticoagulated blood. As the patient was treated before with gold salts, the cause of the thrombocytopenia was assumed to be the consequence of gold therapy. Purpuric lesions however were absent and the bleeding time was again normal. Platelet aggregation tests, starting from citrated Platelet rich plasma (PRP), were completely normal in the three cases. Pseudothrombocytopenia, due to a platelet agglutinin, only active if EDTA is present, was suspected. Platelet clumping, in citrated PRP to which EDTA was added, was looked for and found positive. Other causes of spuriously low platelet counts are discussed and the practical implications stressed.

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