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Saleh Shamse Basha: When Platelet Counts Mislead, The PLT-F Becomes Critical
Saleh Shamse Basha/LinkedIn
Apr 16, 2026, 14:05

Saleh Shamse Basha: When Platelet Counts Mislead, The PLT-F Becomes Critical

Saleh Shamse Basha, Senior Hematology Technologist (Reference Lab, HQ) at PureLab, shared a post on LinkedIn:

“When Platelets Lie… or Do They?

A recent hematology case:

  • Platelet count (impedance): 3844 ×10⁹/L (!!)
  • Histogram: abnormal distribution with clear overlap.
  • Sysmex XR9000 detected abnormal PLT flag and reflexed to PLT-F channel then the PLT: 201×10⁹/L.

Let’s figure it out.

The question is: Is this a true extreme thrombocytosis, or are we looking at a classic analytical pitfall?

Additional findings:

  • Marked microcytosis (MCV: 49.8 fL)
  • Presence of schistocytes on peripheral smear.
  • Anisopoikilocytosis.

In impedance-based counting (Coulter Principle), size is everything.

But when RBCs become very small—as in:

  • Iron deficiency anemia
  • Thalassemia

– and especially with RBC fragmentation (schistocytes)…

The analyzer may misclassify RBC fragments within the platelet size window Resulting in pseudothrombocytosis

That’s where PLT-F (fluorescent platelet count) becomes critical:

It differentiates platelets based on RNA content, not just size.”

Saleh Shamse Basha: When Platelet Counts Mislead, The PLT-F Becomes Critical

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Anisopoikilocytosis Health Hematology Hemostasis Hemostasis News Hemostasis Today Medical Laboratory Medicine Microcytosis Platelet count Saleh Shamse Basha Thrombocytosis
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