EDTA依赖性假性血小板减少1例

A case of EDTA dependent pseudothrombocytopenia

血小板减少为临床常见症状,表现为由于各种原因导致的血小板计数结果低于参考值下限。当血小板减少时可出现一系列症状,如皮肤淤血、鼻出血、口腔黏膜出血等,严重者可出现内脏出血、脑出血甚至危及生命。乙二胺四乙酸二钾(EDTA-K2)为血液分析的常用抗凝剂,但有时会引起血小板聚集,使血小板计数假性减少,临床诊断为EDTA依赖性假性血小板减少症(EDTA-PTCP)。赤壁市蒲纺医院(同济赤壁医院)于2019年12月16日收治1例血小板减少的患者,前后两次血常规检测所得血小板计数结果出现较大偏差,使用EDTA-K2抗凝管检测血常规时,患者的血小板数值低于正常参考值下限(26×10^9/L);改用肝素抗凝管检测时,患者的血小板数值在正常值参考范围内。经血小板人工计数及血涂片复片染色检查等手段复检后,均显示患者血小板数值在正常值参考范围内,证实了该例患者为EDTA-PTCP。

Thrombocytopenia is a common clinical symptom,which shows that the result of platelet (PLT) count is lower than the lower limit of reference value due to various reasons.A series of symptoms can appear in thrombocytopenia,such as congestion of skin,epistaxis,bleeding of oral mucosa and so on.Visceral hemorrhage,cerebral hemorrhage and even life-threatening can occur.Ethylenediamine tetra-acetic acid-K2 (EDTA-K2) is a kind of commonly used anticoagulant in blood analysis,but sometimes it can cause platelet aggregation and pseudodecrease of platelet count.It is clinically diagnosed as EDTA dependent pseudothrombocytopenia(EDTA-PTCP).One case of thrombocytopenia was admitted in Chibi Pufang Hospital (Tongji Chibi Hospital) on December 16,2019.There was large difference in PLT values between the two routine blood examinations of the patient.When using the EDTA-K2 anticoagulant to detect the blood routine,the patient’s PLT value was lower than the lower limit of the normal reference value,and while heparin anticoagulant was applied for reexamination,the patient’s PLT value was within the reference range of the normal value (26×10^9/L).After the manual platelet count and blood smear staining were used to detect the PLT,the patient’s PLT value was within the reference range of the normal value.The patient was diagnosed as EDTA-PTCP.