A 73 year old female is being evaluated for an elective left hip ORIF. Her platelets are found to be 55 x 109/L but “platelet clumping” is commented on her peripheral blood film. What is the cause of platelet clumping? Is this patient a surgical candidate?
Platelet clumping is caused by EDTA (Ethylenediaminetetraacetic acid), the anti-coagulant used in the collection tubes for a CBC.
Such results can be avoided by repeating the platelet count using a citrate tube, as citrate is an anticoagulant and should not interfere with platelet artifact.
So long as the repeat platelet count is acceptable, she should be stable for surgery.