Rosenkranz B, Wisser H, Bode J C
Dtsch Med Wochenschr. 1985 Mar 29;110(13):492-5. doi: 10.1055/s-2008-1068851.
Automated counting resulted in erroneously low numbers of platelets (pseudothrombocytopenia) in three patients. The machine-derived values (ELT-8) were initially 30 000, 8000 and 8000/microliter, respectively. Numerous agglutinates could be demonstrated in the counting chamber. Whereas counting in the first patient showed a real value with an average of 252 000/microliter both the other preparations could not be counted due to numerous agglutinates. The artificially low number of platelets in the counter can thus be explained by lack of recognition as platelets due to the size of the in vitro formation of agglutinates. Should these be of the size of white cells leukocytosis may be suggested. Formation of agglutinates was not limited to use of EDTA as anticoagulant but could also be observed with other anticoagulants such as heparin and citrate. For prevention of superfluous and potentially dangerous therapeutic steps the diagnosis of platelet deficiency should be ascertained in any case by additional determination of the platelet count in the counting chamber.
自动计数导致三名患者的血小板数量错误地偏低(假性血小板减少症)。机器得出的值(ELT - 8)最初分别为每微升30000、8000和8000。在计数室中可发现大量凝集物。第一位患者的计数显示实际值平均为每微升252000,而其他两份样本由于大量凝集物无法计数。计数器中人为偏低的血小板数量可归因于体外形成的凝集物大小导致未被识别为血小板。如果这些凝集物大小与白细胞相同,可能会提示白细胞增多。凝集物的形成不仅限于使用乙二胺四乙酸(EDTA)作为抗凝剂,在使用其他抗凝剂如肝素和柠檬酸盐时也可观察到。为防止不必要的和潜在危险的治疗步骤,无论如何都应通过在计数室中额外测定血小板计数来确定血小板缺乏的诊断。