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Platelet satellitism due to EDTA Anticoagulant

View larger version (163K): [in this window] [in a new window]   Figure 1. 27 year old Hispanic female G2P3 at 16 weeks gestation presented with complaint of diffuse abdominal pain. A routine CBC was reported to show a platelet count of 47k/ul. The anticoagulant routinely used to collect blood for CBC determination is sodium EDTA. A low power view of her peripheral smear shows marked platelet clumping around the neutrophils. This was the first indication that her she had a pseudothrombocytopenia.

View larger version (138K): [in this window] [in a new window]   Figure 2. Multiple platelet clumps are noted adhering to the cytoplasmic membranes of the neutrophils.

View larger version (136K): [in this window] [in a new window]   Figure 3. Another image of the platelet satellitism around the neutrophils is shown. Note the lymphocyte does not show this phenomenon. The vacuolated neutrophil on the left appears to have phagocytized platelets with a blue tint to the cytoplasmic vacuoles.

View larger version (97K): [in this window] [in a new window]   Figure 4. A higher magnification of the previous image is shown.

View larger version (104K): [in this window] [in a new window]   Figure 5. Phagocytosis of platelets by the neutrophil is seen in this view in addition to the adherence of platelets to the neutrophil membrane.

View larger version (195K): [in this window] [in a new window]   Figure 6. A blood smear from the patient made from blood collected in sodium citrate as the anticoagulant is shown. Note the absence of platelet clumping. The automated platelet count using this anticoagulant was reported as 244k/ul.

View larger version (156K): [in this window] [in a new window]   Figure 7. A higher magnification, the sodium citrate smear shows individual platelets and the absence of the platelet satellitism noted in the EDTA sample.

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Platelet Disorders - Quantitative Abnormalities - Mucocutaneous hemorrhage Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?