An
interesting case appeared on Facebook today
“With this patient we didn’t release the
platelet count to the clinician due to the severe platelet clumping as seen in
the pics above. This phenomenon is called platelet satellitism and as some
correctly identified there is also some platelet phagocytosis occurring in the
neutrophils which appear as large vacuoles.
Due to their
agranular appearance we considered grey platelet syndrome but we were able to
rule this out because when a single platelet was seen it had normal
granulation.
We have suggested
that they recollect in a citrate tube to see if we can get a more accurate
platelet count.
We also vortexed the
sample just for interest in an attempt to break up the aggregates and we got a
platelet count of 214 but with no accurate platelet count available we were
unable to determine how close this was to the real result.
This patient has MGUS
and we wonder if this might be playing a part so we have forwarded the film to
our consultant haematologist for comment.”
Satellites
and phagocytosis…
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