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Pseudoplatelets: a retrospective study of their incidence and interference with platelet counting
  1. W van der Meer1,
  2. M A MacKenzie2,
  3. J W B Dinnissen1,
  4. M H de Keijzer1
  1. 1Department of Clinical Chemistry, University Medical Centre St Radboud, 6500 HB Nijmegen, The Netherlands
  2. 2Department of Haematology, University Medical Centre St Radboud
  1. Correspondence to:
 Dr W van der Meer, Department of Clinical Chemistry (564), University Medical Centre St Radboud, PO BOX 9101, 6500 HB Nijmegen, The Netherlands;


Aims: Spurious platelet counts can be found in acute leukaemias, as a result of the fragmentation of blood cells. Microscopic examination of a blood smear should be performed to detect the presence of these so called pseudoplatelets. When present, the platelet count should be corrected because of the important clinical consequences that a lower platelet count may have in these patients.

Methods: K3EDTA anticoagulated blood was measured on an automated blood cell counter, and a blood smear was made and stained according the May Grünwald–Giemsa method for microscopic observation. A 500 cell/particle differentiation was performed and the automated platelet count was corrected.

Results: The incidence of pseudoplatelets in 169 patients with acute leukaemia was studied. Pseudoplatelets were detected in 43 patients (25.4%), and seven patients (4.1%) were re-classified as having a major bleeding risk (platelet count, < 15 × 109/litre).

Conclusions: Platelets should be determined morphologically in patients with acute leukaemia and a routine screening method for the detection of pseudoplatelets should be developed.

  • pseudoplatelets
  • platelet counts
  • acute leukaemia
  • bleeding risk
  • ALL, acute lymphoblastic leukaemia
  • AML, acute myeloid leukaemia
  • CBC, complete blood cell count
  • DIC, disseminated intravascular coagulation

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