Amikacin Can Be Added to Blood to Reduce the Fall in Platelet Count

作者:Zhou, Xiaomian*; Wu, Xiaoli; Deng, Weixiong; Li, Jieqiu; Luo, Wenshen
来源:American Journal of Clinical Pathology, 2011, 136(4): 646-652.
DOI:10.1309/AJCPMON79QKQKRBT

摘要

Our objective was to develop an effective method to prevent the fall in platelet count for patients with anticoagulant-dependent (AD) pseudothrombocytopenia, a spurious phenomenon due to anticoagulant-induced aggregation of platelets. We report a case of insidious multianticoagulant-dependent pseudothrombocytopenia in which AD pseudothrombocytopenia may be caused by 4 anticoagulants, eg, EDTA, sodium citrate, heparin, and sodium fluoride (NaF). Multianticoagulant-dependent pseudothrombocytopenia was confirmed by finding clumped platelets on microscopic evaluation in 4 anticoagulated blood samples. With this case, we tried a variety of reagents, including aminoglycosides, eg, gentamicin and amikacin, vitamin B-6, and aminophylline to inhibit pseudothrombocytopenia. Except for amikacin, all reagents failed to prevent pseudothrombocytopenia. Microscopic examination of K-2-EDTA-, heparin-, sodium citrate-, and NaF-anticoagulated blood samples showed massive platelet clumping, but no aggregate was seen in the anticoagulated blood with amikacin. When amikacin was added within 1 hour after blood sample withdrawal, platelet, WBC, and RBC counts and hemoglobin level, mean corpuscular volume, and mean platelet volume remained unchanged for up to 4 hours at room temperature. These findings suggest that amikacin could inhibit and dissociate pseudo platelet aggregation in multianticoagulant-dependent pseudothrombocytopenia and EDTA-induced pseudothrombocytopenia.