Use of theophylline in the investigation of pseudothrombocytopenia induced by edetic acid (EDTA-2K).

In automated cell counting of edetic acid (EDTA-2K) anticoagulated blood, thrombocytopenia is occasionally seen which bears no relation to any underlying disease. In this study a heparin and soluble theophylline mixture was used to measure accurately platelet numbers in patients with such pseudothrombocytopenia. In four normal volunteers, a theophylline concentration of more than 7 mg/ml produced no significant difference in platelet numbers between theophylline and heparin and EDTA-2K anticoagulated bloods. When blood treated with EDTA-2K was used in seven patients with pseudothrombocytopenia, falsely low platelet counts were observed in three patients immediately after sampling; in blood treated with theophylline, white cell and platelet counts remained unchanged for up to six hours after sampling. Microscopical examination of the EDTA-2K anticoagulated blood showed massive platelet clumping, but no aggregates were seen in theophylline anticoagulated blood. It is concluded that theophylline can be useful in the investigation of pseudothrombocytopenia when an automated cell counter is used.