Preoperative evaluation of EDTA-dependent pseudothrombocytopenia before lumbar disc herniation surgery: A case report

Abstract

Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia (EDTA-PTCP) is an in vitro phenomenon characterized the clustering of platelets following the use of EDTA as an anticoagulant, leading to a decreased analyzer platelet count in a complete blood count (CBC). This report is a description of the case of a 47-year-old male patient admitted to a neurosurgery clinic with the complaints of back and leg pain. A neurological examination and lumbar magnetic resonance imaging revealing extruded disc herniations led to a decision to perform surgery. Thrombocytopenia was detected in the preoperative testing of the patient. The CBC was reanalyzed using citrate. Peripheral blood smears of the patient collected using citrate and EDTA were compared. Thrombocytopenia was not detected in a CBC of the citrated sample and the peripheral smear did not reveal platelet clusters. Pseudothrombocytopenia was considered, as the anamnesis, physical examination findings, and coagulation tests of the patient were not consistent with thrombocytopenia. In conclusion, EDTA-PTCP was diagnosed during the preoperative evaluation of the patient.