ISSN 2997-1036
International Journal of Hematology | Vol. 5, No. 12, December 2014 | pp. 89–96
DOI: 10.46882/2014/IJH/000060
Short Communication
Title: Evaluation of automated platelet clumps flagging efficiency on a five-part differential cell counter
Names of Authors: B. C. Akpan¹, D. E. Usman²
Authors’ Affiliations: ¹Department of Haematology, University of Calabar, Calabar, Nigeria; ²Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria
Abstract: Ethylenediaminetetraacetic acid (EDTA)-induced platelet clamping is a well-known cause of pseudothrombocytopenia, leading to unnecessary clinical consultations and diagnostics. This study evaluated the flagging efficiency and diagnostic accuracy of an automated five-part differential cell counter for detecting platelet clumps in 120 blood samples that triggered a platelet clump flag. Automated results were verified using manual peripheral blood smear evaluation as the reference standard. True platelet clumps were confirmed microscopically in 72.5% (87 of 120) of the flagged samples. In the remaining 33 samples, flags were triggered by micro-clots, giant platelets, or cold agglutinins. The automated counter achieved a positive predictive value of 72.5% for platelet clump detection. Re-collecting samples using sodium citrate tubes in confirmed cases resolved the clamping and corrected the platelet counts, increasing values from a flagged mean of 42.6 × 10⁹/L to a true mean of 214.5 × 10⁹/L. While automated cell counter flags are useful indicators, visual examination of a peripheral blood film remains mandatory to rule out pseudothrombocytopenia before executing clinical management.
Keywords: Pseudothrombocytopenia, platelet clumps, automated cell counter, flagging efficiency, peripheral blood film
Manuscript Timeline: Received: September 15, 2014; Revised: October 22, 2014; Accepted: November 10, 2014; Published: December 12, 2014