Ethylenediaminetetraacetate-dependent pseudothrombocytopenia accompanied by morphological changes

Excerpt

A 65-year-old female patient was referred to our hospital for diabetes mellitus, diabetic nephropathy, pulmonary infection, and hypertension on November 6, 2012. Following admission, findings from laboratory tests were as follows: white blood cell count, 14.76 × 10⁹/L; hemoglobin, 123 g/L; platelet count, 28 × 10⁹/L; creatinine, 272 μmol/L; fasting glucose, 14.26 mmol/L; prothrombin time, 14.6 s; d-dimer, 4800 μg/L. Tests for antinuclear and antineutrophil cytoplasmic antibodies were negative, but were positive for platelet-associated IgG. Dipotassium EDTA, sodium citrate, and heparin sodium were selected as the anticoagulants for blood cell counts, to exclude the influence of EDTA salt. We performed whole-blood cell counts measured by a Sysmex XE-2100 complete blood count analyzer, followed by blood smears and staining with a Sysmex sp1000i automated hematology slide preparation unit. The platelet and white blood cell counts were 12 × 10⁹ and 6.9 × 10⁹/L for EDTA-2K anticoagulants, 242 × 10⁹ and 4.3 × 10⁹/L for sodium citrate anticoagulants, 250 × 10⁹ and 4.6 × 10⁹/L for heparin sodium anticoagulants, respectively. The blood smear results are shown in Figs. 1 and 2.

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