title: [Implementation of the immunological method for improvement on accurate platelet counts].
abstract: Rapid and accurate platelet counting is clinically required in severe thrombocytopenia. Prophylactic platelet transfusions are usually indicated in thrombocytopenia with platelet counts less than 20,000/microliter. It was recently reported that the confidence lower limit of platelet counts by automated blood cell counter is about 14,000/microliter. Clinical blood samples occasionally contain red-cell fragments or large platelets. In these cases, platelets should be counted by the phase-contrast microscopy. However, this manual operation is accurate but not precise and needs complicated technique. Abbott has developed an immunological platelet counting method by CELL-DYN 4000. We measured platelet counts in 137 blood samples from thrombocytopenic patients. These samples included red-cell fragmentation and large platelets on blood smears. We compared platelet counts with the immunological method(PLTimm) to those with Brecher-Cronkite, the optical(PLTo) and the impedance method(PLTi). PLTimm correlated more closely with the phase-contrast microscopy counts than PLTo or PLTi. In patients with microangiopathic hemolytic anemia, PLTo or PLTi could not exclude red-cell fragments, but PLTimm absolutely excluded red-cell fragments. In patients with giant platelets, PLTo or PLTi could not include large platelets but PLTimm included them and coincided well with platelet counts by the phase-contrast microscopy. These results indicate that the immunological method by CELL-DYN 4000 appears to be accurate and a very useful method for accurate platelet counts in severe thrombotybopenia.
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582.
authors.forename: Emiri
authors.initials: E
authors.lastname: Osada
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Inose
authors.forename: Kei
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Yohko
authors.initials: Y
authors.lastname: Kawai
authors.forename: Kiyoaki
authors.initials: K
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D039661:Integrin beta3 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000379:methods*; D012680:Sensitivity and Specificity; D013921:Thrombocytopenia / Q000097:blood
chemical_list: D000906:Antibodies; D039661:Integrin beta3