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一名脓毒症术后患者出现依地酸二钠钙(EDTA)依赖性假性血小板减少症:病例报告

Transient appearance of EDTA-dependent pseudothrombocytopenia in a postoperative patient with sepsis: A case report.

作者信息

Shi Xiang, Lin Zhongyuan, He Liyan, Li Wenchao, Mo Lijun, Li Yinyin, Yang Zheng, Mo Wu-Ning

机构信息

Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

出版信息

Medicine (Baltimore). 2017 Mar;96(11):e6330. doi: 10.1097/MD.0000000000006330.

Abstract

RATIONALE

Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia (EDTA-PTCP) is a rare phenomenon characterized by spuriously low platelet counts when EDTA reacts with harvested blood. However, to the best of our knowledge, only two cases involving EDTA-PTCP in postoperative patients with sepsis have been reported. Here, we describe a case of EDTA-PTCP that appeared transiently in a postoperative patient with sepsis.

PATIENT CONCERNS

A 68-year-old female patient underwent laparoscopic tension-free hernioplasty for incisional hernia. Postoperatively, the patient developed very low platelet counts. The number of platelets in this patient had not improved following treatment with fresh-frozen plasma and platelet transfusions.

DIAGNOSES

The diagnosis of EDTA-PTCP was confirmed from the discovery of platelet aggregation in peripheral blood smears.

INTERVENTIONS

We used sodium citrate-anticoagulated blood samples for platelet counting.

OUTCOMES

The patient's platelet counts returned to normal with the use of sodium citrate-anticoagulated blood samples. Furthermore, the phenomenon of EDTA-PTCP disappeared when the patient was cured.

LESSONS

The phenomenon of low platelet counts in postoperative patients with sepsis should be considered as possible EDTA-PTCP. In addition, peripheral blood smears and the use of sodium citrate anticoagulant are effective and valuable methods that can help identify EDTA-PTCP.

摘要

理论依据

乙二胺四乙酸依赖性假性血小板减少症(EDTA-PTCP)是一种罕见现象,其特征为当EDTA与采集的血液发生反应时血小板计数假性降低。然而,据我们所知,仅有两例术后脓毒症患者发生EDTA-PTCP的病例报告。在此,我们描述一例术后脓毒症患者短暂出现EDTA-PTCP的病例。

患者情况

一名68岁女性患者因切口疝接受腹腔镜无张力疝修补术。术后,患者出现极低的血小板计数。经新鲜冰冻血浆和血小板输注治疗后,该患者的血小板数量并未改善。

诊断

通过在外周血涂片上发现血小板聚集,确诊为EDTA-PTCP。

干预措施

我们使用柠檬酸钠抗凝的血样进行血小板计数。

结果

使用柠檬酸钠抗凝的血样后,患者的血小板计数恢复正常。此外,患者治愈后,EDTA-PTCP现象消失。

经验教训

术后脓毒症患者血小板计数降低的现象应考虑为可能的EDTA-PTCP。此外,外周血涂片检查和使用柠檬酸钠抗凝剂是有助于识别EDTA-PTCP的有效且有价值的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d78/5369911/28684f96e2a8/medi-96-e6330-g001.jpg

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