Traje CELKAN, Handan Hakyemez TOPTAN, Ömer DOĞRU

Yalancı trombositopeni

Tam kan sayımı aletleri günümüzde sıkça kullanılmaktadır. Tam kan sayımında trombosit sayısı düşük olmasına rağmen klinik ve öykü olarak kanama bulgusu olmayan ve EDTA veya sitratlı kandan yapılan kan yaymasında trombositlerin saptanmadığı, ancak doğrudan periferik kandan yapılan yaymada trombositlerin görüldüğü durum psödotrombositopeni olarak tanımlanır. Psödotrombositopeni tanısı koyduğumuz olguyu sunarak bu konuya erişkinden daha nadir olarak karşılaşan çocuk hekimlerinin dikkatini çekmek istedik.

Spurious thrombocytopenia

Nowadays automated blood cell analysis is being widely used. When the history and physical examination do not suggest a defect in hemostasis, the thrombocyte count is found low in blood with the anticogulants EDTA or citrate although a blood film prepared directly from blood optained by finger puncture reveales normal thrombocytes. This thrombocytopenia is called pseudo or spurious thrombocytopenia. Here, sharing our experience on a pseudothromboctopenic child, we want to point to this topic altough it is less common in pediatric patients than adults.

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1. Miers MK, Exton MG, Daniele C. Cell-Counting and Coagulation Instrumentation. In: Bernadette F R (ed). Diagnostic Hematology. Philedelphia: WB Saunders, 1995: 599-631.
2. Wilson DB. Acquired platelet defects. In: Nathan DG,Orkin SH, Ginsburg D, Look AT( eds). Hematology of Infancy and childhood. 6 th ed. Philadelphia: WB Saunders, 2003: 1598-9.
3. James N G. Platelets. Lancet 2000; 355: 1531-9.
4. Said SM, Hahn J, Schleyer E, et al. Glycoprotein IIb/IIIa inhibitor-induced thrombocytopenia: diagnosis and treatment. Clin Res Cardiol 2007; 96: 61-9.
5. Yoneyama A, Nakahara K. EDTA-dependent pseudothrombocytopenia-differentiation from true thrombocytopenia. Nippon Rinsho 2003 ;61: 569-74.
6. Van der Meer W, Allebes W, Simon A, Van Berkel Y, De Keijzer MH. Pseudothrombocytopenia: a report of a new method to count platelets in a patient with EDTA-and temperature-independent antibodies of the IgM type. Eur J Haematol 2002; 69: 243-7.
7. Bragagni G, Bianconcini G, Brogna R, Zoli G. Pseudothrombocytopenia: clinical comment on 37 cases. Minerva Med 2001; 92: 13-7.
8. Zandecki M, Genevıeve F, Gerard J, Godon A. Spurious counts and spurious results on haematology analysers: a review. Part I: platelets. Int J Lab Hematol 2007; 29: 4-20.
9. Mori M, Kudo H, Yoshitake S, Ito K, Shinguu C, Noguchi T. Transient EDTA-dependent pseudothrombocytopenia in a patient with sepsis. Intensive Care Med 2000; 26: 218-20.
10. Kinoshita Y, Yamane T, Kamimoto A, et al. A case of pseudothrombocytopenia during antibiotic administration. Rinsho Byori 2004; 52: 120-3.
11. Yoshikawa H. EDTA-dependent pseudothrombocytopenia induced by valproic acid. Neurology 2003; 61: 579-80.
12. Chiurazzi F, Villa MR, Rotoli B. Transplacental transmission of EDTA-dependent pseudothrombocytopenia. Haematologica 1999; 84: 664.