The Case Report of a Patient Undergoing Hemodialysis with Platelet Cold Agglutinin

Document Type : Case Report

Authors

1 MSc in nursing, Birjand University of Medical Sciences, Birjand, Iran

2 MSc of Hematology and Blood Banking Department of Medical Laboratory Sciences, School of Allied Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 BSc in Laboratory Sciences, Birjand University of Medical Sciences, Birjand, Iran

4 Instructor of Laboratory Hematology and Blood Bank, School of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran

Abstract

Background: The presence of platelet cold agglutinins is a rare phenomenon that causes K-EDTA independent pseudo thrombocytopenia at laboratory temperature. If the peripheral blood smear is not examined, this phenomenon can cause a misdiagnosis of thrombocytopenia.
Methods: The present study examined the platelet count of a 52-year-old man undergoing hemodialysis in the laboratory for the presence of cold agglutinins. The patient's blood sample was collected using K3-EDTA and sodium citrate anticoagulant. The number of platelets was counted at different times and temperatures with a cell counter machine. Peripheral blood smear was examined at the same time as the platelet count by the device. No sign of bleeding was observed in the patient.
Findings: At the time of sampling, platelet count was 164x109/L, but it decreased drastically after storage at laboratory temperature. Moreover, at the end of the peripheral blood smear, a large number of platelet clumps were observed.
Conclusion: Platelet cold agglutination is a rare phenomenon that can lead to laboratory error by inducing pseudo thrombocytopenia. This issue has to be taken into consideration in cases of severe thrombocytopenia without clinical symptoms. Since cold antibodies do not affect in-vivo platelet function, such cases do not show any clinical symptoms; however, it has to be considered in situations such as surgeries performed in hypothermic conditions.

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References

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Journal of Isfahan Medical School
Volume 41, Issue 722
2nd Week, August
July and August 2023
Pages 446-451

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History

  • Receive Date: 10 April 2023
  • Accept Date: 10 July 2023

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