EDTA Dependent Pseudothrombocytopenia In A Patient With Scrub Typhus - A Case Report
Abstract
We report a case of EDTA induced pseudothrombocytopenia in a patient with scrub typhus who was referred as a case of PUO with marked thrombocytopenia and treated with platelet transfusion. Blood smear examination revealed numerous platelet aggregates. CBC analysis using citrate and lithium-heparin as anticoagulants as well as a peculiar WBC histogram  aidedin prompt diagnosis of the condition.The prevalence of EDTA-PTCP in  general hospital population is approximately 0.1%. It is usually not associated with hemorrhagic manifestations. Hence cases of thrombocytopenia should be carefully evaluated to rule out this form of artefactual thrombocytopenia. Timely diagnosis of this innocuous but misleading in vitro phenomenon can save the patient from unnecessary transfusions and invasive procedures.References
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2. Michael Nagler, Peter Keller, Daniel Siegrist and Lorenzo Alberio. A case of EDTA- de-pendent pseudothrombocytopenia: simple recognition ofan underdiagnosed andmisleading phenomenon. BMC Clinical Pathology 2014;14:19.
3. Dalamangas, L. C., & Slaughter, T. F. Ethylenediaminetetraacetic Acid-Dependent Pseu-dothrombocytopenia in a Cardiac Patient. Anesth Analg 1998;86:1210-11.
4. A Casonato, ABertomoro, E Pontara, D Dannhauser, A R Lazzaro, A Girolami. EDTA dependent pseudothrombocytopeniacaused by antibodies against the cytoadhesive receptor of platelet gpIIB-IIIA. J ClinPathol 1994;47:625-30.
5. Mori M, Kudo H, Yoshitake S, et al. Transient EDTA-dependent
pseudothrombocytopenia in a patient with sepsis. Intensive Care Med 2000;26:218-20.
6. Kocum TH, Katircibasi TM, Sezgin AT and Atalay H: An unusual case of mismanagement in an acute myocardial infarction: pseudothrombocytopenia. Am J Emerg Med 2008;26:740.e1-2.
7. Abe H, Shimizu T, Cho H, et al. Occult breast cancer with EDTA-dependent Pseudothrombocytopenia–a case report.GanToKagakyoho. Cancer & Chemotherapy 2010;37:915-18.
8. Reed BW and Go RS.Pseudothrombocytopenia associated with multiple myeloma. Mayo Clin Proc 2006;81:869.
9. Hee Jun Kim, In HoMoh, Hana Yoo, Seungyeon Son, Da Hye Jung, Hun Gu Lee: Ethylenediaminetetraacetic acid dependent pseudothrombocytopenia associated with neuroendocrine carcinoma: A case report. Oncology Letters 2012;3:86-88.
