ITP Patient
Hello! I have this concerning matter regarding this patient’s lab works. Our pathologist informed us very late that this patient has ITP (immune thrombocytopenic purpura) so we weren’t able to collect citrated tube. When we ran EDTA tube, it gave 131 for platelet count. The rerun results then gave 7 and 9. No clots were seen confirmed by two lab techs. On morning shift, the pathologist saw microclots (which we didn’t consider as a clot but for her it was). See photo below. We opted to do reextraction so we were able to collect citrated tube along with an additional EDTA tube. First run of citrated tube, it gave 0 platelets (see photo below) and a schistocyte remark. The EDTA tube didn’t give any results. (see photo below)
Our pathologist doesn’t think that this situation is not connected to his condition. She was saying she doesn’t want to re-extract another sample from this patient again in which she should verify it via manual microscopy and contact the patient for any previous results. She’s saying it’s a pre-analytical error and doesn’t want to rely on manual microscopy. We were able to send the 1st EDTA tube to another lab but they said it’s clotted but they weren’t informed with the patient’s condition so I think they’re just assuming it was clotted as the patient’s platelets were very low.
I would like to ask for some insights. We heavily rely on our patho as she is the one who publishes all the reports but this is already a very obvious case and needs to be further correlated and investigated.
P.S. she doesn’t know how to manually count platelets