ĐÁNH GIÁ TÌNH TRẠNG GIẢM TIỂU CẦU GIẢ TẠO TRONG XÉT NGHIỆM TỔNG PHÂN TÍCH TẾ BÀO MÁU VÀ HIỆU QUẢ CỦA CÁC KỸ THUẬT KHẮC PHỤC TẠI TRUNG TÂM XÉT NGHIỆM MEDLATEC

Abstract

Objectives: To determine the prevalence of pseudothrombocytopenia (PTCP) and to describe the effectiveness of corrective methods applied at the MEDLATEC Laboratory Center.

Methods: A cross-sectional descriptive study was conducted based on laboratory data from 80,872 samples undergoing complete blood count (CBC) testing on the Sysmex XN-3100 analyzer at the MEDLATEC Laboratory Center from August to December 2025.

Results: Among 80,872 samples analyzed on the Sysmex XN-3100 system, 11.133 samples (13,77%) were suspected of PTCP, and 585 samples (0,72%) were confirmed as PTCP. Of the 585 PTCP samples, 71,62% showed platelet-related flags on the analyzer, whereas 28.38% had no platelet flags but were still identified as PTCP. Platelet counts <150 G/L accompanied by analyzer flags were observed in 69,71% of PTCP samples, while 6,32% of samples with platelet counts ≥150 G/L also exhibited PTCP. The prevalence of PTCP increased significantly with prolonged pre-analytical time, from 4,43% within 2 hours to 10,63% after 6 hours (p < 0.05). Vortexing of whole blood samples successfully resolved PTCP in 507 out of 585 cases (86,67%). Among the remaining 78 cases after vortexing, incubation at 37°C was successful in 2 cases (2,56%). Subsequently, repeat blood sampling using both EDTA and 3.2% Natri citrate anticoagulant tubes was performed in the remaining 71 cases, resulting in successful resolution in 40 cases (56,34%) with no platelet clumping in EDTA samples, and in 1 case (1.41%) where platelet clumping persisted in the EDTA tube but was absent in the Natri citrate tube. The remaining 30 cases (5,13%) could not be corrected by these methods and were reported with interpretative comments.

Conclusion: Pseudothrombocytopenia is a clinically significant phenomenon in CBC testing and is markedly influenced by pre-analytical time. Early recognition and appropriate corrective methods are essential to improve the accuracy of platelet count results, to reduce turnaround time without delaying result reporting and ensure patient safety.