title: Platelet satellitism in infectious disease?
abstract: BACKGROUND
  Platelet satellitism is a phenomenon of unknown etiology of aggregating platelets around polymorphonuclear neutrophils and other blood cells which causes pseudothrombocytopenia, visible by microscopic examination of blood smears. It has been observed so far in about a hundred cases in the world.
  Our case involves a 73-year-old female patient with a urinary infection. Biochemical serum analysis (CRP, glucose, AST, ALT, ALP, GGT, bilirubin, sodium, potassium, chloride, urea, creatinine) and blood cell count were performed with standard methods on autoanalyzers. Serum protein fractions were examined by electrophoresis and urinalysis with standard methods on autoanalyzer together with microscopic examination of urine sediment. Erythrocyte sedimentation rate, blood culture and urine culture tests were performed with standard methods.
  
  
  RESULTS
  Due to typical pathological values for bacterial urinary infection, the patient was admitted to the hospital. Blood smear examination revealed phenomenon, which has persisted for three weeks after the disease has been cured. Blood smears with EDTA as an anticoagulant had platelet satellitism whereas the phenomenon was not observed in tubes with different anticoagulants (Na, Li-heparin) and capillary blood.
  
  
  CONCLUSIONS
  We hypothesize that satellitism was induced by some immunological mechanism through formation of antibodies which have mediated platelets binding to neutrophil membranes and vice versa. Unfortunately we were unable to determine the putative trigger for this phenomenon. To our knowledge this is the second case of platelet satellitism ever described in Croatia.
authors.affiliation: Department for Nuclear Medicine and Oncology, University Clinical Hospital Centre Sestre milosrdnice, Zagreb, Croatia.
authors.forename: Valentina
authors.initials: V
authors.lastname: Vidranski
authors.affiliation: Department for Medical Biochemistry, Diagnostic Hematology and Cytology, University Hospital for Infectious Diseases Dr. Fran Mihaljevic, Zagreb, Croatia.
authors.forename: Renata
authors.initials: R
authors.lastname: Laskaj
authors.affiliation: Department for Medical Biochemistry, Diagnostic Hematology and Cytology, University Hospital for Infectious Diseases Dr. Fran Mihaljevic, Zagreb, Croatia.
authors.forename: Dubravka
authors.initials: D
authors.lastname: Sikiric
authors.affiliation: Clinical Department for Urinary Tract Infections, University Hospital for Infectious Diseases Dr. Fran Mihaljevic, Zagreb, Croatia.
authors.forename: Visnja
authors.initials: V
authors.lastname: Skerk
mesh_terms: D000368:Aged; D001792:Blood Platelets / Q000378:metabolism / Q000473:pathology; D017523:Croatia; D005260:Female; D006801:Humans; D009504:Neutrophils / Q000378:metabolism / Q000473:pathology; D010974:Platelet Aggregation; D014552:Urinary Tract Infections / Q000097:blood* / Q000188:drug therapy / Q000473:pathology*
keywords: EDTA; blood platelets; thrombocytopenia; urinary infection