29 September 2011 (Thursday) - Paraprotein, Platelets

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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