title: Amikacin can be added to blood to reduce the fall in platelet count.
abstract: Our objective was to develop an effective method to prevent the fall in platelet count for patients with anticoagulant-dependent (AD) pseudothrombocytopenia, a spurious phenomenon due to anticoagulant-induced aggregation of platelets. We report a case of insidious multianticoagulant-dependent pseudothrombocytopenia in which AD pseudothrombocytopenia may be caused by 4 anticoagulants, eg, EDTA, sodium citrate, heparin, and sodium fluoride (NaF). Multianticoagulant-dependent pseudothrombocytopenia was confirmed by finding clumped platelets on microscopic evaluation in 4 anticoagulated blood samples. With this case, we tried a variety of reagents, including aminoglycosides, eg, gentamicin and amikacin, vitamin B(6), and aminophylline to inhibit pseudothrombocytopenia. Except for amikacin, all reagents failed to prevent pseudothrombocytopenia. Microscopic examination of K(2)-EDTA-, heparin-, sodium citrate-, and NaF-anticoagulated blood samples showed massive platelet clumping, but no aggregate was seen in the anticoagulated blood with amikacin. When amikacin was added within 1 hour after blood sample withdrawal, platelet, WBC, and RBC counts and hemoglobin level, mean corpuscular volume, and mean platelet volume remained unchanged for up to 4 hours at room temperature. These findings suggest that amikacin could inhibit and dissociate pseudo platelet aggregation in multianticoagulant-dependent pseudothrombocytopenia and EDTA-induced pseudothrombocytopenia.
authors.affiliation: Dept. of Laboratory Medicine, Guangzhou First Municipal People's Hospital, Affiliate of Guangzhou Medical College, Guangzhou, PR China.
authors.forename: Xiaomian
authors.initials: X
authors.lastname: Zhou
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Wu
authors.forename: Weixiong
authors.initials: W
authors.lastname: Deng
authors.forename: Jieqiu
authors.initials: J
authors.lastname: Li
authors.forename: Wenshen
authors.initials: W
authors.lastname: Luo
mesh_terms: D000328:Adult; D000583:Amikacin / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000925:Anticoagulants / Q000494:pharmacology*; D002951:Citrates / Q000494:pharmacology; D004492:Edetic Acid / Q000494:pharmacology; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects; D010976:Platelet Count / Q000379:methods*; D000077559:Sodium Citrate; D012969:Sodium Fluoride / Q000494:pharmacology; D013921:Thrombocytopenia / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D002951:Citrates; D000077559:Sodium Citrate; D000583:Amikacin; D012969:Sodium Fluoride; D006493:Heparin; D004492:Edetic Acid