Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med (Zagreb)
Title: Biochemia Medica
Abbreviated Title: Biochem. Med. (Zagreb)
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright statement: ©Croatian Society of Medical Biochemistry and Laboratory Medicine.
Copyright: 2023, Croatian Society of Medical Biochemistry
License (open-access):
This is an Open Access article distributed under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date received: 26 March 2024
Date accepted: 09 September 2024
Publication date: 15 October 2024
Publication date: 15 October 2024
Volume: 34
Issue: 3
Electronic Location Identifier: 030504
Publisher ID: bm-34-3-030504
DOI: 10.11613/BM.2024.030504
National recommendations of the Croatian Chamber of Medical Biochemists and Working group for Laboratory hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine: Management of samples with suspected EDTA-induced pseudothrombocytopenia
Gordana Juričić[3]
Dragana Antončić[4]
Fran Smaić[5]
Brankica Šimac[6]
[1] Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
[2] School of Medicine, Catholic University of Croatia, Zagreb, Croatia
[3] Department of Laboratory Diagnostics, General Hospital Pula, Pula, Croatia
[4] Clinical Department of Laboratory Diagnostics, Rijeka Clinical Hospital Centre, Rijeka, Croatia
[5] Department of Laboratory Diagnostics, General Hospital Dr. Josip Benčević, Slavonski Brod, Croatia
[6] Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
[7] Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
[8] University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
[9] Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
[10] Department of Sport and Exercise Medicine, University of Zagreb, Faculty of Kinesiology, Zagreb, Croatia
Author notes:
[*] Corresponding author: laramilevoj@gmail.com
Author contributions
L Milevoj Kopčinović: Conceptualization, Methodology, Writing - original draft, Visualisation, Writing – review & editing; G Juričić: Conceptualization, Methodology, Writing - original draft, Writing – review & editing; D Antončić: Methodology, Writing - original draft, Writing – review & editing; F Smaić: Writing - original draft, Writing – review & editing. B Šimac: Methodology, Writing - original draft, Writing – review & editing. I Lapić: Methodology, Writing - original draft, Writing – review & editing. V Radišić Biljak: Conceptualization, Methodology, Writing - original draft, Writing – review & editing.
• National recommendations aim to harmonize the management of EDTA-induced pseudothrombocytopenia
• The influence of preanalytical errors should be excluded
• The presence of platelet clumps should be confirmed by peripheral blood smear inspection
• Platelet counts should be determined from the 3.2% sodium citrate sample
• If EDTA-induced pseudothrombocytopenia is confirmed, platelet counts are reported with appropriate comments
Pseudothrombocytopenia (PTCP) is defined by the occurence of spouriously low platelet count as a consequence of in vitro platelet aggregation. It is a rare and benign artifact, not associated with any specific disorder or therapy, that becomes clinically relevant when it is not timely and reliably recognized. Thus, it may result in inappropriate clinical decisions (i.e. unnecessary further testing, misdiagnoses and potential patients’ mismanagement) unavoidably compromising patient safety. The most common form of PTCP is caused by ethylenediaminetetraacetic acid (EDTA). Several approaches for the management of samples with EDTA-induced PTCP have been described in the literature. However, expert recommendations are scarce. The scope of these recommendations is to assist in achieving national harmonisation in laboratory management (i.e. detecting and reporting platelet counts) of samples with EDTA-induced PTCP. These minimal recommendations were prepared by the members of the joint working group of the Croatian Chamber of Medical Biochemists and Working group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, and might be customized according to specific conditions (i.e. personnel and equipment) of each individual laboratory. These recommendations are primarily intended to all laboratory professionals involved in the management of samples with EDTA-induced PTCP, but also to other healthcare professionals involved in collecting samples and interpreting complete blood count results.
Keywords: thrombocytopenia; pseudothrombocytopenia; hematology analyzers; procedures; harmonisation