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Asmaa A About Pseudo Thrombocytopenia: Causes and How to Handle 
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Oct 21, 2025, 06:44

Asmaa A About Pseudo Thrombocytopenia: Causes and How to Handle 

Asmaa A, DHA Medical Laboratory Technologis at Al-Ahrar International Hospital, shared a post on LinkedIn:

“Pseudo Thrombocytopenia — Causes & How to Handle

the analyzer shows low PLT even though the patient’s actual platelet count is normal.
This can mislead diagnosis unless recognized early.
The most common causes are five :

  1. Platelet Clumping (EDTA-dependent platelet agglutinins)
    Common in EDTA samples — platelets stick together and appear fewer.
    How to handle:
    • Recollect in sodium citrate, multiply PLT & WBC ×1.1
    • Or keep the EDTA sample at 37°C before analysis to prevent clumping
  2. Platelet Satellitism
    Platelets attach to WBCs, especially neutrophils (EDTA-related).
    How to handle:Recollect in sodium citrate, multiply PLT & WBC ×1.1
  3. Rouleaux Formation
    Seen in multiple myeloma, RBCs stack like coins → analyzer misreads counts.
    How to handle: Wash with saline and rerun.
  4. Giant Platelets
    Large PLTs are counted as RBCs → falsely low PLT.
    How to handle: Check peripheral blood smear (PBF) manually.
  5. Clotted Sample
    Due to poor mixing or delayed processing.
    How to handle: Reject and recollect properly.

Always check the peripheral smear before reporting a low PLT count ,it could save you from a false report!”

Asmaa A About Pseudo Thrombocytopenia: Causes and How to Handle 

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Al-Ahrar International Hospital Asmaa A EDTA-dependent platelet agglutinins EDTA-related Giant Platelets Health Hematology Hemostasis Hemostasis Today Medicine Pseudo Thrombocytopenia
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