A. Bay et al. / Open Journal of Pediatrics, 2011, 1, 39-40
40
can cross the placenta and cause thrombocytopenia in
neonate [5]. This case documents transplacental trans-
mission of the plasmatic factor probably an IgG, respon-
sible for pseudthrombocytopenia. If there is thrombocy-
topenia, a peripheral blood smear with blood counts,
taken into tubes containing citrate or heparin as antico-
agulant should be performed.
In case of low thrombocyte level which ob tained with
an electronic counter peripheral smear should be prepar-
ed from both patient’s fingertip and blood sample with
EDTA. Also platelet count should be repeated with an-
other anticoagulant like citrate or heparin instead of
EDTA. Repeated thrombocyte counts with other antico-
agulants are usually found normal in range. Thrombo-
cytes sometimes surround in leucocytes (thrombocyte
satellism) which form a cluster. These clusters can not be
counted correctly by electronic blood counter instru-
ments. So this should be ruled out when thrombocyto-
penia is detected. It should be kept in mind that low
thrombocyte counts can be obtained due to aggregation
of thrombocyte when blood samples are taken improp-
erly (insufficient mix of anticoagulant and blood sample,
difficulty in venous access). When low platelet counts
are found from the blood samples of patients whom have
been difficulties in venous access, peripheral blood
smear should be done and examined under microscope.
MPV (mean platelet volume) is also measured in full
blood count instruments beside thrombocyte count. In
patients with low platelet levels; if MPV value is high
the differential diagnosis should include acute ITP, Ber-
nard-Soulier syndrome and also one should always re-
member the possibility of formation of thrombocyte
clusters and further investigation should be performed
according to these causes .
One has to decide if thrombocytopenia is real or
pseudo before making further diagnostic tests, a periph-
eral smear should always be done with complete blood
counts.
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