A Case of Pseudothrombocytopenia in a Patient Undergoing Emergency Laparotomy

• Published in: Nihon Rinshō Masui Gakkai shi Vol. 18; no. 2; pp. 195 - 199
• Main Authors: ASAHARA, Hirozumi, ITO, Tatsushi
• Format: Journal Article
• Language: English
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 1998
• Subjects: EDTA; Pseudothrombocytopenia; Thrombocytopenia
• ISSN: 0285-4945; 1349-9149
• DOI: 10.2199/jjsca.18.195

A 48-year-old woman underwent emergency laparotomy for pelvic abscess and a tumor. The preoperative data were within normal limits except those for inflammatory parameters, and her platelet count was 287, 000/μl. Upon complete blood analysis at the beginning of surgery, platelet count was only 8, 000/μl. There was no tendency of bleeding in the surgical field, however, which was not consistent with the data. As the surgery progressed, blood loss increased and we therefore ordered concentrated platelets for transfusion. At the same time, we inquired of a physician in charge and of a hematologist about such extreme throm-bocytopenia. They clarified that the patient was also suffering from pseudothrom-bocytopenia, a condition caused by an anticoagulant EDTA (ethylene diamine tetra acetic acid) in a sample tube. Pseudothrombocytopenia is a EDTA-induced platelet clumping phenomenon which results in underestimation of the number of platelets by automated cell counters. When low platelet count is not accompanied by symptoms of bleeding or disseminated intravascular coagulation, awareness of pseudothrombocytopenia may avoid erroneous therapies.