Anticoagulant-induced pseudothrombocytopenia in a patient presenting for coronary artery bypass grafting.
A 73-yr-old man with severe ischaemic heart disease presented for coronary artery bypass grafting. His preoperative platelet count, obtained from an ethylene diamine tetraacetic acid (EDTA) sampling bottle, was 61 x 10(9) litre-1, but he had no history of bleeding problems. Previous platelet counts demonstrated results ranging from 16 x 10(9) litre-1 to 254 x 10(9) litre-1 with variable degrees of in vitro platelet clumping. Preoperative thrombelastography reflected a normal coagulation profile. The laboratory findings and the absence of a history of haemorrhagic complications suggested a diagnosis of EDTA-dependent pseudothrombocytopenia. We present the perioperative implications of this in vitro phenomenon and methods of detecting the functional and numerical integrity of circulating platelets.
Wilkes
N J
NJ
Department of Anaesthesia, Royal Free Hampstead NHS Trust, London, UK.
Smith
N A
NA
Mallett
S V
SV
D000368:Aged; D001026:Coronary Artery Bypass; D004492:Edetic Acid / Q000009:adverse effects*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood / Q000150:complications; D010976:Platelet Count / Q000379:methods; D013916:Thrombelastography; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced*
D004492:Edetic Acid