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Clinical Laboratory Apr 2024Platelet (PLT) count is one of the most important parameters of automated hematology, as spurious PLT reports could affect medical judgement and bring significant risks....
BACKGROUND
Platelet (PLT) count is one of the most important parameters of automated hematology, as spurious PLT reports could affect medical judgement and bring significant risks. In most cases, spurious PLT will not be reported for review criteria, which will be triggered by abnormal PLT histograms and PLT flag(s). Here, we present a case of severe aplastic anemia after hematopoietic stem cell transplantation with spurious high platelet count with normal histogram and no PLT flag(s).
METHODS
The electrical impedance channel (PLT-I) and the fluorescence channel (PLT-F) of Sysmex XN-series hematology analyzer was used to obtain PLT results. Then, the sample was retested by another hematology analyzer MINDRAY BC-7500 [NR] CRP, and incubation was performed to rule out cryoglobulin interference. Furthermore, a microscope was used to estimate the PLT count by the ratio of platelets to red blood cells and observe the morphology of cells.
RESULTS
Both PLT-I and PLT-F test results were spuriously high, and microscopically assessed platelet counts were relatively reliable. The observed spiny cells and ghost cells caused by hemolysis may have contributed to the inaccuracy of instrumental counting in this case.
CONCLUSIONS
For special hematologic patients, PLT-I with flags may not be sufficient for screening purposes and PLT-F is not always accurate. Multiple testing methods including manual microscopy are needed.
Topics: Humans; Platelet Count; Anemia, Aplastic; Reproducibility of Results; Blood Platelets; Agmatine; Oxamic Acid
PubMed: 38623668
DOI: 10.7754/Clin.Lab.2023.231119 -
Transfusion Medicine (Oxford, England) Apr 2014To study the effect of extended storage of platelet concentrates (PCs) and the implementation of a new platelet pooling system for PCs on corrected count increment (CCI)... (Comparative Study)
Comparative Study Observational Study
Implementation of a new platelet pooling system for platelet concentrates led to a higher corrected count increment after transfusion: a comparative observational study of platelet concentrates before and after implementation.
OBJECTIVES
To study the effect of extended storage of platelet concentrates (PCs) and the implementation of a new platelet pooling system for PCs on corrected count increment (CCI) after transfusion.
BACKGROUND
Due to new developments and changes in processes or procedures, one should remain alert for the effects of these changes. Besides in vitro studies and validation, in vivo studies are also important, as it has been shown that in vitro results do not always predict in vivo outcomes.
METHODS/MATERIALS
After introduction of extended storage of PCs for 5-7 days prepared from five buffy coats and plasma, transfusion monitoring for transfusions of PCs in haemato-oncological patients was set up. After 9 months, a new pooling system for PCs was implemented, Composelect instead of Optipure PLT, and transfusion monitoring was continued for another 8 months. The CCI was used as primary outcome.
RESULTS
In total, 93 patients were included and transfused with PCs prepared in the Optipure PLT system (262 transfusions) or in the Composelect system (127 transfusions). Extended storage of PCs for 7 days had no significant effect on CCI. Although the implementation of the Composelect system did not influence the CCI1 h (13.8 ± 6.0 vs. 13.0 ± 5.8; n.s.), it seemed to have a positive effect on CCI24 h (7.0 ± 4.9 vs. 4.7 ± 4.5; P < 0.05).
CONCLUSION
Although the influence of confounders could not be excluded, it seemed that implementation of the Composelect system for PCs led to an improved CCI24 h and that extended storage of PCs did not influence the CCI.
Topics: Blood Platelets; Blood Preservation; Female; Humans; Male; Platelet Count; Platelet Transfusion
PubMed: 24506143
DOI: 10.1111/tme.12105 -
Current Hematology Reports Mar 2006Accurate platelet counts in severe thrombocytopenia are critical in clinical practice to facilitate decisions at prophylactic platelet-transfusion thresholds. Until... (Review)
Review
Accurate platelet counts in severe thrombocytopenia are critical in clinical practice to facilitate decisions at prophylactic platelet-transfusion thresholds. Until recent years, the accuracy of platelet counts has been limited by the reliance of hematology analyzers on calibration material values derived from the manual platelet counting method. The calibration of hematology analyzers in thrombocytopenia and the reduction of variation between instruments have been hindered by a lack of adequate quality control materials, making the accuracy of automated methodologies in routine practice difficult to assess. This situation could now be vastly improved by the use of the International Reference Method (IRM) to assign calibration materials and by further knowledge of the accuracy and limitations of the particular types of automated platelet count available to the clinician. These changes will improve clinical confidence in the accuracy of a platelet count and thus inform clinical decisions at the current level of prophylactic platelet transfusions.
Topics: Automation; Calibration; Humans; Platelet Count; Platelet Transfusion; Thrombocytopenia
PubMed: 16537049
DOI: No ID Found -
International Journal of Laboratory... Jun 2009The accuracy of three automated haematology analysers [Sysmex XE-2100 (both optical and impedance mode), Bayer Advia 120, and Beckman Coulter LH-750] was compared with... (Comparative Study)
Comparative Study
Platelet count evaluation using three automated haematology analysers compared with the immunoplatelet reference method, and estimation of possible inadequate platelet transfusion.
The accuracy of three automated haematology analysers [Sysmex XE-2100 (both optical and impedance mode), Bayer Advia 120, and Beckman Coulter LH-750] was compared with the immunoplatelet reference method for platelet measurement. A total of 165 blood specimens were obtained from patients and platelet counts were determined using the four-automated haematology analyser methods and the immunoplatelet reference method. The coefficients of determination (R(2)) between the automated haematology analyser methods and the immunoplatelet reference method for the overall platelet range were >0.98. A bias study, however, showed some disagreement. The use of a coincidence correction calculation for the immunoplatelet method did not improve the correlation between the immunoplatelet method and the automated haematology analyser methods. To estimate the possibility of inadequate platelet transfusion, the number of prophylactic platelet transfusion indications determined by the automated haematology analyser platelet counts were compared with the number of transfusion indications according to the platelet counts determined by the immunoplatelet method. An additional 48 blood specimens were included in this analysis. All of the automated haematology analysers showed some disagreement in the transfusion indications when compared with the immunoplatelet method, suggesting the possibility of inadequate platelet transfusion.
Topics: Humans; Immunologic Tests; Platelet Count; Platelet Transfusion; Reference Standards; Reference Values
PubMed: 18294237
DOI: 10.1111/j.1751-553X.2008.01032.x -
Cirugia Y Cirujanos 2024This study aimed to evaluate the value of platelet activation markers in predicting preeclampsia and its severity. Preeclampsia is a serious pregnancy complication that...
OBJECTIVE
This study aimed to evaluate the value of platelet activation markers in predicting preeclampsia and its severity. Preeclampsia is a serious pregnancy complication that affects 3-5% of pregnancies and can lead to significant morbidity and mortality for both the mother and the fetus.
METHODS
The study included 99 patients diagnosed with preeclampsia and 60 healthy pregnant women as a control group. Platelet activation markers such as mean platelet volume (MPV), platelet distribution width (PDW), platelet count, and plateletcrit were evaluated along with other clinical parameters.
RESULTS
The results of the study showed that platelet activation markers, particularly PDW and MPV, are valuable in the diagnosis and follow-up of preeclampsia. However, they are not sufficient to predict the severity of the disease.
CONCLUSION
The study suggests that platelet activation markers could aid in predicting, diagnosing, and managing preeclampsia. However, further research is needed to determine the role of these markers in predicting the severity of the disease. The findings of this study could contribute to the development of more effective strategies for the prevention and management of preeclampsia, which could ultimately improve maternal and fetal outcomes.
Topics: Humans; Female; Pregnancy; Pre-Eclampsia; Mean Platelet Volume; Platelet Activation; Platelet Count; Pregnancy Complications
PubMed: 38537226
DOI: 10.24875/CIRU.23000226 -
Veterinary Clinical Pathology Sep 2023Platelet function testing is important for monitoring the effects of antiplatelet therapy but is not readily used due to time constraints for testing and the need for...
BACKGROUND
Platelet function testing is important for monitoring the effects of antiplatelet therapy but is not readily used due to time constraints for testing and the need for specialized equipment.
OBJECTIVES
This study evaluated the effects of various storage methods on selected platelet function tests to determine if delayed platelet function testing is feasible in canine blood samples. Our hypotheses were that platelet function would not decline during storage and, thus, no differences in test results would be found over time.
METHODS
Thirteen healthy dogs were studied. Citrated blood samples were tested with a Platelet Function Analyzer-200 (PFA), which mimics high-shear conditions, using P2Y and CADP cartridges, after being held at room temperature for 2 h and refrigerated for 24 and 48 h. Plateletworks (PW), which measures aggregation based on platelet counting, was performed on an optical hematology analyzer using 10-min-old native samples, citrated samples held at room temperature for 3-4 h and refrigerated for 24 and 48 h, and samples stored in the preservative solution, AGGFix, up to 7 days.
RESULTS
PFA closure times increased with storage, especially with the P2Y cartridge. Median aggregation with fresh PW was 94%, and this was maintained at all time points (range of median values 88%-94%). Most samples showed decreased, yet still robust (>70%), aggregation with longer storage. Spontaneous aggregation in citrate was noted in most dogs. AGGFix stabilized platelet aggregates to allow for delayed testing.
CONCLUSIONS
Delayed platelet function testing is feasible, but ranges of expected values may differ from tests using fresh samples.
Topics: Dogs; Animals; Platelet Aggregation; Platelet Function Tests; Blood Platelets; Platelet Count; Hemostasis
PubMed: 37385948
DOI: 10.1111/vcp.13226 -
Blood Coagulation & Fibrinolysis : An... Oct 2015Depression is associated with poor prognosis for cardiovascular disease (CVD) including mortality. Among multiple mechanisms linking depression and CVD, changes in...
Depression is associated with poor prognosis for cardiovascular disease (CVD) including mortality. Among multiple mechanisms linking depression and CVD, changes in platelet reactivity are known to be one of the major confounders of such adverse association. However, there are very limited data in children. Thus, we evaluated some conventional hemostatic indices including whole blood platelet aggregation in patients with documented pediatric depression and compared these data with those obtained from healthy children. The pediatric patients fulfilled criteria for major depression with a minimum score of 19 on the 21-item Beck Depression Inventory Scale. Plasma fibrinogen, D-dimer, platelet count, mean platelet volume, and platelet aggregation induced by ADP and collagen were measured in 67 pediatric patients with depression and matched by age and sex with 78 healthy controls. As expected, the depressed children had significantly higher BECK scales (P = 0.001) compared with the normal subjects. Platelet aggregation induced by ADP and collagen (P = 0.0001 for both) was significantly higher in depressed children. BECK scale scores correlated significantly with platelet aggregation induced by ADP (r = 0.3, P = 0.001) and collagen (r = 0.4, P = 0.01). In contrast, platelet counts, fibrinogen, D-dimer, mean platelet volume, and antithrombin-III levels were almost identical between both groups. Children with depression exhibit mostly intact hemostatic parameters, with the exception of significantly higher platelet activity when compared with healthy controls. These data match well with prior evidence from depressed adults supporting the hypothesis that platelets participate in the pathogenesis of depression. However, beyond pure assessment of platelet activity, other elements including serotonin content and cell receptor changes in pediatric depression should be elucidated before randomized trial(s) can be justified.
Topics: Adolescent; Child; Depression; Female; Humans; Male; Platelet Count; Platelet Function Tests
PubMed: 25688456
DOI: 10.1097/MBC.0000000000000245 -
American Journal of Clinical Pathology Aug 1980The Coulter Counter model S-Plus measures the erythrocyte, leukocyte, and platelet counts, and the mean cell volume of erythrocytes and platelets. Two additional...
The Coulter Counter model S-Plus measures the erythrocyte, leukocyte, and platelet counts, and the mean cell volume of erythrocytes and platelets. Two additional features are novel to the instrument: erythrocyte distribution width (RDW), an index of erythrocyte volume heterogeneity, and mean platelet volume. For 677 subjects, we compared these measurements with complete blood counts obtained by a standard instrument, platelet counts from platelet-rich plasma (PRP), and histograms of erythrocyte and platelet volumes generated by free-standing equipment. The two methods correlated well (r = 0.97) for the complete blood count and the mean platelet volume. The whole-blood platelet count correlated well (r = 0.97) with the PRP platelet count, with whole-blood counts on average 5% higher than PRP counts. The whole-blood index of erythrocyte volume heterogeneity, RDW, correlated less well (r = 0.81) with the erythrocyte coefficient of variation measured by histogram. RDW was abnormal for three of 100 normal subjects with normal histograms. RDW was less sensitive (78% vs. 97%) and less specific (94% vs. 97%) than erythrocyte histograms in distinguishing iron deficiency from heterozygous alpha- or beta-thalassemia. We conclude that the Coulter Counter Model S-Plus reliably measures complete blood cell count, platelet count, and mean cell volumes, but analyzes erythrocyte volume distribution less well than does a histogram.
Topics: Blood Cell Count; Blood Volume; Erythrocyte Volume; Evaluation Studies as Topic; Humans; Particle Size; Platelet Count
PubMed: 7405893
DOI: 10.1093/ajcp/74.2.157 -
Schweizerische Medizinische... Nov 1986Pseudothrombocytopenia, a term used to define a spuriously low platelet count produced by automatic cell counters, is most often due to platelet clumping induced by...
Pseudothrombocytopenia, a term used to define a spuriously low platelet count produced by automatic cell counters, is most often due to platelet clumping induced by EDTA. In a period of two years we have observed 8 patients with a mean platelet count of 46,000/mm3 in the presence of EDTA. When samples of capillary blood (without EDTA) were tested, the mean platelet count was 202,000/mm3. A further patient had platelet adherence to neutrophils with normal platelet counts. This rare finding can also lead to pseudothrombocytopenia. In the event of unexpected thrombocytopenia a smear from EDTA-blood samples reveals the presence of platelet clumping or adherence to neutrophils. Counts of capillary blood samples reveal the true platelet number.
Topics: Adult; Aged; Aged, 80 and over; Edetic Acid; Female; Humans; Male; Middle Aged; Platelet Aggregation; Platelet Count
PubMed: 3097820
DOI: No ID Found -
Vox Sanguinis Oct 2004The blood platelet content (in numbers) of platelet concentrates is required for production quality control and to predict clinical responses. (Comparative Study)
Comparative Study
BACKGROUND AND OBJECTIVES
The blood platelet content (in numbers) of platelet concentrates is required for production quality control and to predict clinical responses.
MATERIALS AND METHODS
This study compared the performance of automated counting from impedance and optical instruments to data from immunoplatelet reference analysis.
RESULTS
All methods showed good linearity with evidence of significant instrument-specific deviations from the line of agreement. Relational formulae largely corrected bias, but did not resolve platelet count variability. A second confounding factor, related to the proportion of small (activated) platelets, was also shown to contribute to intermethod discrepancies.
CONCLUSIONS
Blood processing centres should establish correction factors for each instrument compared to reference methods, such as the immunoplatelet count.
Topics: Analysis of Variance; Bias; Electric Impedance; Humans; Norway; Optics and Photonics; Platelet Count; Platelet Transfusion; Quality Control
PubMed: 15569073
DOI: 10.1111/j.1423-0410.2004.00557.x