Huss B, Kretschmer V, Schnabel M, Weinel R, Ulshöfer B
Abteilung für Transfusionsmedizin und Gerinnungsphysiologie, Universitätsklinik Marburg, Deutschland.
Infusionsther Transfusionsmed. 1995 Oct;22(5):303-9.
Pseudothrombocytopenia (PTP) is an in vitro phenomenon with falsely low platelet counts determined automatically. Usually the thrombocytopenia is noticed accidentally without a corresponding tendency to bleeding. If this phenomenon is not recognized, misinterpretation may bring the patient into a considerable risk by diagnostical and therapeutical mistakes. By own cases and analysis of the literature, causes, appearance. incidence, as well as diagnostic and clinical problems of PTP shall be explained in detail.
We report on three patients who showed a significant decrease of platelet counts after surgery DIC (disseminated intravascular coagulation) and heparin-induced thrombocytopenia type II (white clot syndrome) were assumed primarily. In all three cases the reason for the low postoperative platelet counts was found to he due to PTP caused by cold agglutinins.
From the cases described it can he concluded that PTP may develop during postoperative clinical course. Due to the broad differential diagnostic spectrum in the postoperative situation. PTP is hardly considered. Therefore, there is a greater chance of misinterpretation and therapeutic mistakes. In case of low platelet counts PTP should always be excluded, even when thrombocytopenia seems to be explicable differently.
假性血小板减少症（PTP）是一种体外现象，自动检测时血小板计数会出现假性降低。通常血小板减少是偶然发现的，且无相应的出血倾向。如果这种现象未被识别，误诊和误治可能会给患者带来相当大的风险。通过自身病例及文献分析，将详细阐述PTP的病因、表现、发病率以及诊断和临床问题。
我们报告了3例患者，术后血小板计数显著降低，最初考虑为弥散性血管内凝血（DIC）和肝素诱导的II型血小板减少症（白血栓综合征）。在所有3例病例中，术后血小板计数降低的原因均为冷凝集素导致的PTP。
从所描述的病例可以得出结论，PTP可能在术后临床过程中发生。由于术后情况的鉴别诊断范围广泛，PTP很难被考虑到。因此，误诊和治疗错误的可能性更大。在血小板计数降低的情况下，即使血小板减少似乎可以用其他原因解释，也应始终排除PTP。
