Elaheh Mansouri: Platelet Clumping Is a Common Pre-Analytical and Analytical Challenge in Haematology
Elaheh Mansouri, Laboratory Supervisor at Kernel Diagnostic Laboratories, shared a post on LinkedIn:
“Small details on a blood film can significantly impact clinical interpretation.
Platelet clumping (platelet aggregation) is a common pre-analytical and analytical challenge in haematology.
It refers to the aggregation of platelets in vitro, which can lead to falsely low platelet counts (pseudothrombocytopenia) on automated analysers.
Common causes of platelet clumping include:
- EDTA-induced platelet aggregation (most common)
- Delayed sample processing
- Difficult venepuncture or traumatic collection
- Inadequate mixing of the sample
Why it matters:
- May result in incorrect reporting of thrombocytopenia
- Can lead to unnecessary investigations or clinical concern
- Affects analyser accuracy and flagging
Laboratory approaches:
- Always review the blood film when platelet count is low or flagged
- Look for platelet clumps, often at the edges of the smear
- Repeat testing using citrate or heparin anticoagulated samples if needed
In this image, platelet clumping can be clearly observed, highlighting the importance of manual verification alongside automated results.
Even small artefacts like this can make a big difference (attention to detail is everything in laboratory medicine).
This image was taken during my time working in a hospital laboratory in Iran.”
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