An interesting case. Platelet clumping is a
well recognised cause of falsely low platelet counts. It is usually an effect
of the EDTA anticoagulant, and a genuine platelet count can be obtained by
taking the blood sample into a different anticoagulant.
This patient had clumped platelets evident in
the blood film regardless of the anticoagulant used.
Whilst originally diagnosed with AML, there
were also circulating plasma cells and a high paraprotein level. It would seem
that platelet clumping in this case was due to the abnormally raised
paraprotein level. As the paraprotein level was reduced, so the platelet
clumping subsided.
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