Pseudothrombocytopenia due to platelet aggregates in an infant: A case report

Autores/as

  • Esteban Artunduaga-Cañas Unidad Central del Valle del Cauca-UCEVA, Colombia
  • Esteban Pineda Arias Unidad Central del Valle del Cauca-UCEVA, Colombia
  • Estefania Rivera Velásquez Unidad Central del Valle del Cauca-UCEVA, Colombia
  • Juan Sebastián Arango Duque Unidad Central del Valle del Cauca-UCEVA, Colombia
  • Juan Diego Rivera Villota Unidad Central del Valle del Cauca-UCEVA, Colombia
  • Diego Fernando López Muñoz Unidad Central del Valle del Cauca-UCEVA, Colombia

DOI:

https://doi.org/10.54502/msuceva.v3n2a3

Palabras clave:

Ethylenediaminetetraacetic acid (EDTA), autoantibodies, platelet aggregation, Pseudothrombocytopenia, thrombocytopenia

Resumen

This case report describes the finding of EDTA-dependent Pseudothrombocytopenia in an 8-month-old infant, an extremely rare condition not reported in the literature. The patient presented with a fever due to insect bite and was diagnosed with abscessed cellulitis. A complete blood count showed a thrombocytopenia of 47 mil/L, with no history of bleeding or hematologic disease. The following day a new test was performed, which showed a platelet count of 214 mil/L, which was not consistent with the expected evolution of a real thrombocytopenia. Pseudothrombocytopenia was suspected and confirmed by observing platelet aggregates in the blood smear and upon recounting in a tube with sodium citrate, showed a normal value of 298 mil/L. Treatment consists of avoiding the use of EDTA as an anticoagulant and using other anticoagulants such as citrate or heparin. Timely identification of this phenomenon is essential to avoid diagnostic confusion and unnecessary or harmful treatment. This case brings to the scientific literature an example of EDTA-dependent Pseudothrombocytopenia in a pediatric patient, which can be easily confused with other causes of thrombocytopenia and requires a high index of clinical suspicion.

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Biografía del autor/a

Esteban Artunduaga-Cañas, Unidad Central del Valle del Cauca-UCEVA, Colombia

Fifth year medical student at the Unidad Central del Valle del Cauca, Colombia. Passionate about research in haematology, surgery and internal medicine. I am a member of the Centre for Research in Communicableu Infectious Diseases (EINTRANS) of the Department of the Faculty of Health, with national and institutional recognition in research.

Esteban Pineda Arias, Unidad Central del Valle del Cauca-UCEVA, Colombia

Fourth year medical student at the Unidad Central del Valle del Cauca, Colombia. I am a member of the Communicable Diseases Research Centre (EINTRANS) in the Department of Health Sciences of the UCEVA. My focus is to actively participate in research projects in this field, contributing to the advancement of knowledge in the field of medicine.

Estefania Rivera Velásquez, Unidad Central del Valle del Cauca-UCEVA, Colombia

Fifth year medical student at the Unidad Central del Valle del Cauca UCEVA, Colombia. I am passionate about research and analysing issues, and my goal is to actively participate in research projects that contribute to the development of medicine and science.

Diego Fernando López Muñoz, Unidad Central del Valle del Cauca-UCEVA, Colombia

Professor at the Faculty of Health Sciences of the Central Unit of Valle del Cauca, Colombia. Bacteriologist of the Catholic University of Manizales. MsC in Biomedical Sciences from the University of Castilla-La Mancha, Spain and Specialist in Transfusion Medicine from the Autonomous University of Barcelona, Spain. He is currently the director of the Research Group on Communicable Infectious Diseases - ENITRANS.

 

Citas

Gauer RL, Braun MM. Thrombocytopenia. Am Fam Physician 2012;85:612–22. PMID: 22534274.

Reibán Espinoza EA, Sanmartín Calle YA, Reibán Sanmartín EA. Trombocitopenia por agregados plaquetarios: reporte de caso. Revista de La Facultad de Ciencias Médicas de La Universidad de Cuenca 2020;38:65–71. https://doi.org/10.18537/RFCM.38.01.09 DOI: https://doi.org/10.18537/RFCM.38.01.09

Gowland E, Kay HEM, Spillman JC, Williamson JR. Agglutination of platelets by a serum factor in the presence of EDTA. J Clin Pathol 1969;22:460–4. https://doi.org/10.1136/jcp.22.4.460 DOI: https://doi.org/10.1136/jcp.22.4.460

Schuff-Werner P, Mansour J, Gropp A. Pseudo-thrombocytopenia (PTCP). A challenge in the daily laboratory routine? Journal of Laboratory Medicine 2020;44:295–304. https://doi.org/10.1515/labmed-2020-0099 DOI: https://doi.org/10.1515/labmed-2020-0099

Zandecki M, Genevieve F, Gerard J, Godon A. Spurious counts and spurious results on haematology analysers: a review. Part II: white blood cells, red blood cells, haemoglobin, red cell indices and reticulocytes. Int J Lab Hematol 2007;29:21–41. https://doi.org/10.1111/j.1365-2257.2006.00871.x DOI: https://doi.org/10.1111/j.1365-2257.2006.00871.x

Nagler M, Keller P, Siegrist D, Alberio L. A case of EDTA-dependent pseudothrombocytopenia: simple recognition of an underdiagnosed and misleading phenomenon. BMC Clin Pathol 2014; 14:19. https://doi.org/10.1186/1472-6890-14-19 DOI: https://doi.org/10.1186/1472-6890-14-19

Silvestri F, Virgolini L, Savignano C, Zaja F, Velisig M, Baccarani M. Incidence and Diagnosis of EDTA‐Dependent Pseudothrombocytopenia in a Consecutive Outpatient Population Referred for Isolated Thrombocytopenia. Vox Sang 1995;68:35–9. https://doi.org/10.1111/j.1423-0410.1995.tb02542.x. DOI: https://doi.org/10.1159/000462884

Bizzaro N. EDTA‐dependent pseudothrombocytopenia: A clinical and epidemiological study of 112 cases, with 10‐year follow‐up. Am J Hematol 1995;50:103–9. https://doi.org/10.1002/ajh.2830500206 DOI: https://doi.org/10.1002/ajh.2830500206

Costa BMB, Vellés MC, Viana MMFB, Pereira ACM, Rocha SCP, Rocha LP, et al. Thrombogram: case report of pseudothrombocytopenia. J Bras Patol Med Lab 2020;56. https://doi.org/10.5935/1676-2444.20200005 DOI: https://doi.org/10.5935/1676-2444.20200005

England JM, Rowan RM, van Assendelft OW, Bull BS, Coulter W, Fujimoto K, et al. Recommendations of the International Council for Standardization in Haematology for Ethylenediaminetetraacetic Acid Anticoagulation of Blood for Blood Cell Counting and Sizing: International Council for Standardization in Haematology: Expert Panel on Cytometry. Am J Clin Pathol 1993;100:371–2.

https://doi.org/10.1093/ajcp/100.4.371 DOI: https://doi.org/10.1093/ajcp/100.4.371

Lippi G, Plebani M. EDTA-dependent pseudothrombocytopenia: further insights and recommendations for prevention of a clinically threatening artifact. Clin Chem Lab Med 2012;50. https://doi.org/10.1515/cclm-2012-0081 DOI: https://doi.org/10.1515/cclm-2012-0081

Greenberg L., EM, S., Kaled ES. Thrombocytopenia. Crit Care Nurs Clin North Am 2013;25:427–34. https://doi.org/10.1016/j.ccell.2013.08.003 DOI: https://doi.org/10.1016/j.ccell.2013.08.003

Morales M, Moreno A, Mejía M, Bustamante Y. Pseudotrombocitopenia edta-dependiente: Rol del laboratorio clínico en la detección y el correcto contaje plaquetario. Revista de La Facultad de Medicina 2001;24.

http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0798-04692001000100008

Kovacs F, Varga M, Pataki Z, Rigo E. Pseudothrombocytopenia with multiple anticoagulant sample collection tubes. Interv Med Appl Sci 2016; 8:181–3. https://doi.org/10.1556/1646.8.2016.4.4 DOI: https://doi.org/10.1556/1646.8.2016.4.4

Kim Hj, Moh Ih, Yoo H, Son S, Jung Dh, Lee Hg, et al. Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia associated with neuroendocrine carcinoma: A case report. Oncol Lett 2012; 4:86–8. https://doi.org/10.3892/ol.2012.675 DOI: https://doi.org/10.3892/ol.2012.675

Lewis S, Bain B, Bates I. Hematología práctica de Dacie y Lewis. 9th ed. Porto Alegre, Brasil: Artmed; 2006.

Carrillo Esper R, Morales Victorino N, Ramírez Rosillo F. Pseudotrombocitopenia: reporte de un caso y revisión de la bibliografía. Med Int Mex 2009; 25:163–8. https://www.medigraphic.com/pdfs/medintmex/mim-2009/mim092i.pdf.

Shabnam I. Ethylenediaminetetraacetic Acid (EDTA) – Dependent Pseudothrombocytopenia: A Case Report. Journal of Clinical and Diagnostic Research 2014. https://doi.org/10.7860/JCDR/2014/9603.5019 DOI: https://doi.org/10.7860/JCDR/2014/9603.5019

MindRay. HemaBook Capítulo 1: Historias de cúmulos plaquetarios. HemaBook 2009.

https://www.mindray.com/mx/media-center/blogs/the-stories-of-platelet-clump#.

Sarasa Bosque C, Arruga Mombiela C, Denizon Arranz S. Aprendiendo de los errores: fenómeno EDTA. SEMERGEN - Medicina de Familia 2009;35:106–7. https://doi.org/10.1016/S1138-3593(09)70430-7 DOI: https://doi.org/10.1016/S1138-3593(09)70430-7

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Publicado

2023-12-01

Cómo citar

1.
Artunduaga-Cañas E, Pineda Arias E, Rivera Velásquez E, Arango Duque JS, Rivera Villota JD, López Muñoz DF. Pseudothrombocytopenia due to platelet aggregates in an infant: A case report . Magna Sci. UCEVA [Internet]. 1 de diciembre de 2023 [citado 7 de mayo de 2024];3(2):143-9. Disponible en: http://revistas.uceva.edu.co/index.php/magnascientia/article/view/83

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Sección

Medicina (Medicine)

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