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Milad Abdalla: When 180,000 Becomes 45,000 – The EDTA Trap
May 9, 2026, 16:11

Milad Abdalla: When 180,000 Becomes 45,000 – The EDTA Trap

Milad Abdalla, Medical Laboratory Technologist at Al Yalayis Government Transactions Center, shared a post on LinkedIn:

“When 180,000 Becomes 45,000: The EDTA Trap

The analyzer flagged severe thrombocytopenia. The patient looked completely healthy.

The peripheral smear revealed the truth.

‘EDTA-dependent pseudothrombocytopenia.’

EDTA causes platelets to clump ‘in the tube’ — not in the patient.

The automated counter mistakes these clumps for one large cell and reports a falsely low count.

Simple ways to resolve it:

  • Recollect in a ‘Sodium Citrate‘ tube and multiply the result by 1.1
  • Process the sample within 1 hour before significant clumping occurs
  • Warm the sample at 37°C for 10 minutes to disperse early clumps

We encountered this exact case last month during a pre-op screening. A ‘critical’ platelet count of 45,000 turned into a normal 180,000 on citrate. The patient proceeded to surgery instead of a hematology referral.

‘Key takeaway:’

Never trust a platelet count that doesn’t match the clinical picture or the blood smear.

Have you seen EDTA-dependent pseudothrombocytopenia in your lab or practice?

What tipped you off — the instrument flag, the smear, or clinical suspicion?”

Milad Abdalla

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bleeding disorders Blood Blood Smear EDTA EDTA-dependent pseudothrombocytopenia Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine Milad Abdalla Sodium Citrate thrombocytopenia
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