Pseudothrombocytopenia due to platelet aggregates in an infant: A case report

Abstract

This case report describes the finding of EDTA-dependent Pseudothrombocytopenia in an 8-month-old infant, an extremely rare condition not reported in the literature. The patient presented with a fever due to insect bite and was diagnosed with abscessed cellulitis. A complete blood count showed a thrombocytopenia of 47 mil/L, with no history of bleeding or hematologic disease. The following day a new test was performed, which showed a platelet count of 214 mil/L, which was not consistent with the expected evolution of a real thrombocytopenia. Pseudothrombocytopenia was suspected and confirmed by observing platelet aggregates in the blood smear and upon recounting in a tube with sodium citrate, showed a normal value of 298 mil/L. Treatment consists of avoiding the use of EDTA as an anticoagulant and using other anticoagulants such as citrate or heparin. Timely identification of this phenomenon is essential to avoid diagnostic confusion and unnecessary or harmful treatment. This case brings to the scientific literature an example of EDTA-dependent Pseudothrombocytopenia in a pediatric patient, which can be easily confused with other causes of thrombocytopenia and requires a high index of clinical suspicion.