EDTA vs CITRATE Platelet counts

From: Fareed Al-Gurg (algurg7f@emirates.net.ae)
Date: Fri Oct 20 2000 - 02:09:23 EST


Hello Flow'ers
Here is an interesting finding that may be known by many but not by all.
It may be helpful for those of us who are doing platelet studies.

When doing a platelet count (using an ETDA anticoagulant blood sample) a
low platelet count is obtained with some samples.
This due to platelet clumps showing many platelets as ONE or gating
these platelets out because their clumped size is close to that of a
micro RBC.
Platelet satelitism is another suspect.
When these patients samples are repeated using a CITRATE sample instead,
TWO different categories emerge:
a- A normal platelet count is obtained with a so-called "EDTA artefact
patients".
	The other blood indices are inaccurate - ONLY the platelet count is
correct.
	The FBC or CBC should be reported with the CITRATE platelets and EDTA
WBC & RBC data.
b- A low platelet count is obtained (almost identical to EDTA samples).
	This is a genuine LOW platelet count that can be confirmed with both
slide viewing and manual counting of platelets.

So, before reporting that platelet count as LOW:
	Check the sample for micro clots.
	Make a blood film and check if they are really low.
	Check it with a CITRATE sample (to get a count if it is normal).
	DO NOT REPORT FBC OF A CITRATED SAMPLE - only the Platelet count!

Any input or correction from the panel members is of great help to us
all.

Regards
Fareed Al-Gurg
Dubai Hospital
Dubai - UAE



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