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April 22, 1974

Artifactual Thrombocytopenia

JAMA. 1974;228(4):464. doi:10.1001/jama.1974.03230290020018

To the Editor.—  Although I have never personally seen a case of platelet satellism as described in "Spurious Thrombocytopenia" (227:628, 1974), some thoughts on the subject have occurred to me. In that report, as in an earlier one,1 the finding of circumneutrophilic platelets is noted only in the absence of ionized calcium. It was not observed in native or heparinized blood, or when calcium was not completely chelated, ie, it did not occur when citrate or oxalate were employed as anticoagulants. It would be of interest to determine the importance of calcium in this phenomenon by taking heparinized blood from such a patient, adding edetic acid (EDTA) to it to cause platelet satellism, and then titering the EDTA to determine the least amount of it that could bind sufficient calcium to induce the phenomenon.In addition, as the process only affects platelets and neutrophils,2 there is also an