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Novel method to dissociate platelet clumps in EDTA-dependent pseudothrombocytopenia based on the pathophysiological mechanism

  • Hyojin Chae , Myungshin Kim , Jihyang Lim , Eun-Jee Oh , Yonggoo Kim EMAIL logo and Kyungja Han EMAIL logo
Published/Copyright: March 3, 2012
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 50 Issue 8

Abstract

Background: EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is an in vitro phenomenon of platelet clumping that leads to spuriously low platelet counts by automatic hematology analyzers. The mechanism is not clearly defined, but is known as an immunologically mediated phenomenon due to the presence of EDTA-dependent antiplatelet auto-antibodies that induce platelet clumping. The purpose of this study was to identify antiplatelet antibodies in EDTA-PTCP samples and to design a method to dissociate platelet clumps based on the pathophysiological mechanism.

Methods: The antiplatelet antibody was investigated using direct and indirect immunofluorescent flow cytometric methods in 23 EDTA-anticoagulated whole blood (WB) samples and 12 serum samples of EDTA-PTCP patients, respectively. A novel mixture containing 9 mmol/L CaCl2and 0.1 unit/L sodium heparin, that provides calcium replacement while curbing coagulation, was designed to dissociate platelet clumps. The effect on dissociation was demonstrated in 26 samples of EDTA-PTCP and compared with the established method of kanamycin supplementation.

Results: The direct test was positive for IgM and IgG antiplatelet antibody in 60.9% and 4.4% of patients, respectively [mean median fluorescence intensity (MFI) of 223.9 and 128.4, respectively]. The indirect test was positive for IgM antiplatelet antibody in 58.3% of patients (mean MFI of 123.4). The novel method dissociated the platelet clumps with a mean increased platelet count of 242.3% and was equivalent in efficiency to kanamycin supplementation.

Conclusions: The novel method is an easily applicable and efficient measure that allows dissociation of platelet clumps, based on the pathophysiological mechanism of EDTA-PTCP.

Keywords: CD41; EDTA-dependent pseudothrombocytopenia; platelet glycoprotein IIb
Corresponding authors: Yonggoo Kim and Kyungja Han, Department of Laboratory Medicine, Seoul St. Mary’s Hospital, 505 Banpo-dong, Seocho-gu, Seoul, 137-701, Korea Phone: +82 2 22581643, Fax: +82 2 22581719
Received: 2011-11-29
Accepted: 2012-2-6
Published Online: 2012-03-03
Published in Print: 2012-08-01

©2012 by Walter de Gruyter Berlin Boston

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  1. Masthead
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https://doi.org/10.1515/cclm-2011-0892
Keywords for this article
CD41; EDTA-dependent pseudothrombocytopenia; platelet glycoprotein IIb

Articles in the same Issue

  1. Masthead
  2. Masthead
  3. Editorial
  4. EDTA-dependent pseudothrombocytopenia: further insights and recommendations for prevention of a clinically threatening artifact
  5. Reviews
  6. Mitochondria as sources and targets of damage in cellular aging
  7. Application of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in Alzheimer’s disease
  8. Opinion Papers
  9. The intellectual contribution of laboratory medicine professionals to research papers on laboratory medicine topics published in high-impact general medicine journals
  10. Laboratory medicine and sports: between Scylla and Charybdis
  11. Guidelines and Recommendations
  12. The EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine: version 4 – 2012
  13. Genetics And Molecular Diagnostics
  14. Assessing the utility of whole genome amplified DNA as a template for DMET Plus array
  15. General Clinical Chemistry And Laboratory Medicine
  16. Effect of acceleration forces during transport through a pneumatic tube system on ROTEM® analysis
  17. The transferrin/log(ferritin) ratio: a new tool for the diagnosis of iron deficiency anemia
  18. Instructions on laboratory monitoring in 200 drug labels
  19. Lipid peroxidation markers in Crohn’s disease: the associations and diagnostic value
  20. Impact of asthmatic control status on serum cystatin C concentrations
  21. Elevated levels of Nɛ-homocysteinyl-lysine isopeptide in patients on long-term hemodialysis
  22. Interleukin-1α gene variants influence bone mineral density and the risk of osteoporotic hip fractures in elderly Slovenian people
  23. Novel method to dissociate platelet clumps in EDTA-dependent pseudothrombocytopenia based on the pathophysiological mechanism
  24. Proficiency testing/external quality assurance for the PFA-100®
  25. Interference of selected flavonoid aglycons in platelet aggregation assays
  26. Infectious Diseases
  27. Monocyte chemoattractant protein-1 and paraoxonase-1 and 3 levels in patients with sepsis treated in an intensive care unit: a preliminary report
  28. Association between ischemia-modified albumin, homocysteine, vitamin B12 and folic acid in patients with severe sepsis
  29. Evidence for serum miR-15a and miR-16 levels as biomarkers that distinguish sepsis from systemic inflammatory response syndrome in human subjects
  30. The predictive value of immature granulocyte count and immature myeloid information in the diagnosis of neonatal sepsis
  31. Hypophosphatemia, fever and prolonged length of hospital stay in seronegative PCR positive patients as compared to seropositive patients with early acute Q fever pneumonia
  32. Cancer Diagnostics
  33. Diagnostic value of HE4 for ovarian cancer: a meta-analysis
  34. Cardiovascular Diseases
  35. Reactive oxygen metabolites (ROMs) are associated with cardiovascular disease in chronic hemodialysis patients
  36. Methylenetetrahydrofolate reductase C677T and reduced folate carrier 80 G>A polymorphisms are associated with an increased risk of conotruncal heart defects
  37. Oxidative stress as a predictor of cardiovascular events in coronary artery disease patients
  38. Behavioral and clinical correlates of high-sensitivity C-reactive protein in Japanese men and women
  39. Letters to the Editor
  40. Hemoglobin Rambam has a constant retention time on the Tosoh G8 and interferes with the measurement of HbA1c
  41. Measurement of glycated hemoglobin in a patient with homozygous hemoglobin E
  42. Congress Abstracts
  43. 56th National Congress of the Hungarian Society of Laboratory Medicine
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