Enewa Onoja: Three Misleading Platelet Counts Caused by Platelet Satellitism
Enewa Onoja, Medical Laboratory Scientist at Cerba Lancet Nigeria, shared a post on LinkedIn:
“Platelet Satellitism: when one phenomenon creates three false counts.
Platelet satellitism is an in vitro phenomenon in which platelets adhere to neutrophils, most commonly in EDTA blood samples.
It can produce pseudothrombocytopenia and pseudoneutropenia on automated full blood count analysers.
Less frequently, it may also result in pseudo-eosinophilia.
And in the case behind today’s reference image, all three occurred simultaneously.
So, how does this happen?
1. Pseudothrombocytopenia
When platelets adhere to neutrophils, fewer platelets remain freely suspended in the sample, causing the analyser to count fewer platelets than are actually present, producing a falsely low platelet count.
2. Pseudoneutropenia
Because platelets are attached to neutrophils, some neutrophil-platelet complexes may not be recognised and classified as neutrophils by the analyser. This can result in a falsely reduced neutrophil count.
3. Pseudoeosinophilia
Automated haematology analysers classify cells using parameters such as size, light scatter and staining characteristics. Platelet-neutrophil complexes can alter these optical characteristics and depending on the analyser, some complexes may be misclassified as eosinophils, producing a falsely elevated eosinophil count.
This is why a seemingly alarming full blood count can sometimes tell a very different story from the blood film.
In such cases, peripheral blood film should be examined and manual differential count reported instead.
A sodium citrate or heparin sample should be collected to get an accurate platelet count.
Automation has without a doubt improved accuracy and TAT in the laboratory.
However cases like this are a good reminder that although the analyser provides data, the scientist provides the interpretation.”
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