Razan Suliman: When do we use sodium citrate instead of EDTA for a CBC?
Razan Suliman, Medical Laboratory Specialists at Qater medical lab, shared a post on LinkedIn:
”A patient’s platelet count comes back extremely low.
The clinician is concerned. The patient has no signs of bleeding. The result doesn’t match the clinical picture.
So, what’s going on?
Could the platelet count be wrong?
Before diagnosing thrombocytopenia, laboratory professionals should ask an important question:
Is EDTA the problem?
Although EDTA is the anticoagulant of choice for routine CBC testing, there are situations where it can cause platelet clumping in vitro. As a result, the analyzer may report a falsely low platelet count, a phenomenon known as EDTA-dependent pseudothrombocytopenia.
In such cases, the solution may be surprisingly simple:
Collect a new sample in a sodium citrate tube.Sodium citrate can prevent the platelet clumping seen with EDTA, helping us obtain a more accurate platelet count and avoid unnecessary investigations or treatments.
When do we use sodium citrate instead of EDTA for a CBC?
- When platelet clumping is observed on the blood film.
- When the platelet count is unexpectedly low and does not correlate with the patient’s condition.
- When EDTA-dependent pseudothrombocytopenia is suspected.
Remember: Not every low platelet count is a true thrombocytopenia.
Question for laboratory professionals: Have you ever encountered EDTA-induced platelet clumping in your practice? How was it identified and resolved?”

Stay updated with Hemostasis Today.
-
Jul 13, 2026, 20:17Julia R. Coleman: Fantastic First Day at ISTH 2026
-
Jul 13, 2026, 20:11Ruah Alyamany: Combination Therapy Improves Quality of Life in ITP
-
Jul 13, 2026, 19:47Brian O Mahony: Two-Year Results of BBM-H901 Gene Therapy Presented at ISTH 2026
-
Jul 13, 2026, 19:37Sara Zalghout: Connecting With Colleagues From All Over the World at ISTH 2026
-
Jul 13, 2026, 18:54Alfonso J. Tafur: New Evidence on Perioperative Anticoagulation in Cancer at ISTH 2026
-
Jul 13, 2026, 18:42Jessica Garcia: Thrombin Generation in Type 3 VWD With an Inhibitor on Emicizumab
-
Jul 13, 2026, 18:19Fionnuala Ní Áinle: High-Quality Evidence for DVT Diagnosis in Pregnancy at ISTH 2026
-
Jul 13, 2026, 17:39Pascal Boulanger: Send a Postcard to Your Lab Staff From ISTH 2026
-
Jul 13, 2026, 17:21Stefano Navarro: Presenting Our Recently Published Article at ISTH 2026