What is a known cause of falsely decreased platelet counts?

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Multiple Choice

What is a known cause of falsely decreased platelet counts?

Falsely decreased platelet counts often come from platelet satellitosis. This is when platelets stick to neutrophils in EDTA-treated blood, forming small clusters around the white cells. Automated hematology analyzers count platelets as discrete particles based on size, so platelets that are attached to neutrophils aren’t counted separately. The result is a lower reported platelet count even though the true number is higher. You can see the clumping on a peripheral smear as platelets clustered around neutrophils. To confirm, examine the smear and consider repeating the CBC using a different anticoagulant such as citrate or heparin. If the platelet count normalizes with another anticoagulant, it indicates pseudothrombocytopenia due to platelet satellitosis. Other options like giant platelets, normal distribution, or low activation don’t typically cause this EDTA-dependent artifact.

Falsely decreased platelet counts often come from platelet satellitosis. This is when platelets stick to neutrophils in EDTA-treated blood, forming small clusters around the white cells. Automated hematology analyzers count platelets as discrete particles based on size, so platelets that are attached to neutrophils aren’t counted separately. The result is a lower reported platelet count even though the true number is higher. You can see the clumping on a peripheral smear as platelets clustered around neutrophils.

To confirm, examine the smear and consider repeating the CBC using a different anticoagulant such as citrate or heparin. If the platelet count normalizes with another anticoagulant, it indicates pseudothrombocytopenia due to platelet satellitosis. Other options like giant platelets, normal distribution, or low activation don’t typically cause this EDTA-dependent artifact.

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