Am J Leuk Res | Volume 7, Issue 1 | Research Article | Open Access

Immune Thrombocytopenia with Associated Pseudothrombocytopenia

Pujol-Moix N^1,2*, Español I^1,2,3, Soler A^1,4 and Muñiz-Díaz E⁵

¹Platelet Pathology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain ²Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain ³Department of Hematology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain ⁴Department of Hematology, Hospital Universitari Parc Taulí, Barcelona, Spain ⁵Immunohematology Laboratory, Banc de Sang i Teixits de Catalunya, Barcelona, Spain

^*Correspondance to: Núria Pujol-Moix 

Abstract

Immune Thrombocytopenia with associated Pseudothrombocytopenia (ITP-PTCP) is a condition combining features of both disorders. Patients exhibit low automated platelet counts which partly reflects the true thrombocytopenia intrinsic to ITP, together with the false thrombocytopenia due to the platelet clumps intrinsic to PTCP. Microscopic platelet counts are higher but, unlike pure PTCP, do not reach normal values. Patients with ITP-PTCP experience less bleeding than expected based on automated platelet counts. We described nine patients with ITP-PTCP who met the following diagnostic criteria: 1) low automated platelet counts, 2) microscopic platelet counts 50% higher than automated counts, but below normal, 3) platelet clumps in blood smears. The patients, predominantly adult women, exhibited mild or no bleeding. In six cases, the patients and/or their relatives had associated autoimmune disorders. ITP and/or PTCP were detected in the relatives of six patients. Positive platelet autoantibodies and/or cryptoantibodies were found in five patients. Automated platelet counts were consistently low, being below 50 × 109/L in seven cases. Microscopic platelet counts were at least 70% higher than automated counts. Platelet clumps were observed in all cases. Six patients displayed persistent ITP-PTCP during long-term follow-up, another patient evolved to PTCP and the other two progressed to ITP. Our findings suggest: 1) ITP-PCTP may be more prevalent than previously recognized; 2) Patients with ITP-PTCP share characteristics with both ITP and PTCP patients; 3) The coexistence of ITP and PTCP underlines the strong relationship between these platelet disorders, implying they may represent different phases of the same process.

Keywords:

Immune thrombocytopenia; Pseudothrombocytopenia; Platelet clumps; Platelet counts

Citation:

Pujol-Moix N, Español I, Soler A, Muñiz- Díaz E. Immune Thrombocytopenia with Associated Pseudothrombocytopenia. Am J Leuk Res. 2024; 7(1): 1034..