EDTA-associated pseudothrombocytopenia: definition and real-world occurrence

Objectives: To better characterize occurrence and extent of anticoagulant-associated pseudothrombocytopenia (PTCP) in the daily routine of a high-throughput clinical laboratory in order to draw conclusions on a more precise definition of this phenomenon. Methods: Concomitant platelet counts in both EDTA and citrate whole blood (WB) performed in our laboratory over a period of four years and 9 months, were analyzed, calculating the correlation, as well as the absolute difference in the results obtained from both materials, cross-referencing these measures with automated flags for platelet aggregates and the results of the visual examination for platelet aggregates of peripheral blood smears. Results: Platelet counts in both materials were strongly correlated (ρ=0.86; p<0.0001) but are on average significantly higher in EDTA WB than in citrate WB (median difference: 11 ± 14.8/nL, p<0.0001). This is in spite of numerous instances of EDTA-associated PTCP recorded in our data, where the opposite is the case. The automated flag for possible platelet aggregates was shown to be very unspecific, while a machine-learning algorithm suggested the difference in platelet counts between EDTA and citrate WB as a predictor of platelet aggregates. Conclusions: EDTA-associated PTCP is a regular occurrence. Differences in platelet counts between EDTA and citrate WB appear to be a far better predictor of PTCP than automated flags. A clear and useful definition of PTCP is still missing, however, and cannot be derived from our data either, indicating the need for further research.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: EDTA-associated pseudothrombocytopenia: definition and real-world occurrence ; volume:47 ; number:3 ; year:2023 ; pages:105-114 ; extent:10 ; Journal of laboratory medicine ; 47, Heft 3 (2023), 105-114 (gesamt 10)

Contributors, Places and Time

• Creator: Markewitz, Robert ; Sharifzadeh, Shahpour Reza ; Junker, Ralf ; Wandinger, Klaus-Peter

Further information

• DOI: 10.1515/labmed-2023-0032
• URN: urn:nbn:de:101:1-2023060814055783335433
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.08.2025, 10:58 AM CEST