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June 11, 1982

Segmented Erythrocytes Mistaken for Platelets

JAMA. 1982;247(22):3083. doi:10.1001/jama.1982.03320470031025

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To the Editor.—  Concerning the letter of Lindquist et al (1981;246:2577), we wonder again how one can rely on the counting of thrombocytes of such low levels in such a disease.Recently we compared the counts and peripheral blood smears in two cases of thrombotic thrombocytopenic purpura (TTP), and the impression we gained was that most of the "thrombocytes" are tiny microangiopathic erythrocytes. Examining more than once the buffy coats and staining with PAS confirmed our impression. Many times the number of thrombocytes must be much lower than the number given. Probably the same occurs during some phase of the induction treatment in acute leukemias, where particles of destroyed cells may imitate the thrombocytes.