EDTA-dependent pseudothrombocytopenia complicated by eosinophilic pneumonia

Am J Emerg Med. 2013 Jul;31(7):1157.e5-7. doi: 10.1016/j.ajem.2013.03.033. Epub 2013 May 21.

Abstract

EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is a phenomenon that occurs in vitro when EDTA reacts with harvested blood. EDTA-dependent pseudothrombocytopenia usually does not indicate thrombocytopenia in vivo. Here, we report the first case of EDTA-PTCP complicated by eosinophilic pneumonia. A 70-year-old man with rectal cancer was admitted to the hospital for a liver abscess and rectal cancer. At the time of admission, his platelet count was 20,000/μL, but a peripheral blood smear showed platelet aggregation and the platelet count for a kanamycin-added EDTA blood sample was 180,000/μL. The patient's respiratory status worsened after treatment for the liver abscess and rectal cancer. The patient's bronchoalveolar lavage contained 45% eosinophils, and a diagnosis of acute eosinophilic pneumonia was made. In recent studies, the occurrence of eosinophilic disease has been shown in idiopathic thrombocytopenic purpura. EDTA-dependent pseudothrombocytopenia is an in vitro phenomenon, although platelet activation that results in eosinophil invasion may occur in severe cases.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticoagulants*
  • Blood Coagulation Tests
  • Edetic Acid*
  • Humans
  • Male
  • Pulmonary Eosinophilia / complications
  • Pulmonary Eosinophilia / diagnosis*
  • Thrombocytopenia / blood
  • Thrombocytopenia / complications
  • Thrombocytopenia / diagnosis*

Substances

  • Anticoagulants
  • Edetic Acid