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Pseudothrombocytopenia in Case of Acute Viral Hepatitis A

Yıl 2018, Cilt: 19 Sayı: 1, 79 - 81, 30.04.2018

Öz

Pseudothrombocytopenia is a laboratory-based iatrogenic phenomenon. Pseudothrombocytopenia is not important in terms of bleeding and does not require transfusion of thrombocytopenia. If not identified at the early stages, pseudothrombocytopenia can lead to patients undergoing unnecessary investigations and overtreatment. Here we present a childhood case of pseudothrombocytopenia caused by hepatitis A virus (HAV) infection. A 9-year-old male was referred to our department for thrombocytopenia (thrombocyte count 70x109 /L). The liver was palpable 3-4 cm below the costal margin. Leukocyte count was 6.52x109/L, hemoglobin 14.7 g/L, hematocrit 46.6%, thrombocyte count 58x109 /L. Aspartate transaminase 79.8 U/L, alanine transaminase 116.9 U/L, gamma-glutamyl transferase 156 U/L, alkaline phosphatase 1114 U/L, total bilirubin 0.98 mg/dL, and direct bilirubin 0.6 mg/dL. Other biochemistry values were normal. Anti HAV immunoglobulin M and immunoglobulin G were positive. The patient was diagnosed with hepatitis A. A peripheral smear revealed many thrombocyte clusters composed of 10-20 cells. HAV infection was thought to be the reason for pseudothrombocytopenia. The pseudocytopenia started to recover as the HAV infection got better and the thrombocyte count increased to over 150x109 /L at the end of a year. Peripheral smear evaluation is critical for accurate detection of thrombocytopenia and should be considered the initial step in cases with a familial or medical history of thrombocytopenia.

Kaynakça

  • 1. Celkan T, Toptan HH, Doğru Ö. Spurious thrombocytopenia. Turk Arch Ped 2009; 44: 73-4.
  • 2. Küçümkaya RD, Chen J, Geddis A, Lopez JA. Thrombocytopenia. In: Kaushansky K, Litchman MA, Beutler E, Kipps TJ, Seligsohn U, Prchal JT, editors. Williams hematology, 8th ed. China: McGraw-Hill, 2010: 1891-1928.
  • 3. Cohen AM, Cycowitz Z, Mittelman M, Lewinski UH, Gardyn J. The incidence of pseudothrombocytopenia in automatic blood analyzers. Haematologia (Budap) 2000; 30: 117-21.
  • 4. Holmes MB, Kabbani S, Watkins MW, Battle RW, Schneider DJ. Images in cardiovascular medicine. Abciximab-associated pseudothrombocytopenia. Circulation 2000; 101: 938-9.
  • 5. Bragagni G, Bianconcini G, Brogna R, Zoli G. \[Pseudothrombocytopenia: clinical comment on 37 cases]. Minerva Med 2001; 92: 13-7.
  • 6. Tomonari A, Hirai K, Aoki H, Mima N, Kashiwagi S, Masuda K, et al. \[Pure red cell aplasia and pseudothrombocytopenia associated with hepatitis A]. Rinsho Ketsueki 1991; 32: 147-51.
  • 7. Choe WH, Cho YU, Chae JD, Kim SH. Pseudothrombocytopenia or platelet clumping as a possible cause of low platelet count in patients with viral infection: a case series from single institution focusing on hepatitis A virus infection. Int J Lab Hematol 2013; 35: 70-6.
  • 8. Akıncı B, Akarsu M, Yener S, Saygılı F, Özcan MA, Akpınar H. Edta induced pseudothrombocytopenia in a patient with hepatitis a infection. DEU Journal of Medical Faculty 2005; 19: 50-4.
Yıl 2018, Cilt: 19 Sayı: 1, 79 - 81, 30.04.2018

Öz

Kaynakça

  • 1. Celkan T, Toptan HH, Doğru Ö. Spurious thrombocytopenia. Turk Arch Ped 2009; 44: 73-4.
  • 2. Küçümkaya RD, Chen J, Geddis A, Lopez JA. Thrombocytopenia. In: Kaushansky K, Litchman MA, Beutler E, Kipps TJ, Seligsohn U, Prchal JT, editors. Williams hematology, 8th ed. China: McGraw-Hill, 2010: 1891-1928.
  • 3. Cohen AM, Cycowitz Z, Mittelman M, Lewinski UH, Gardyn J. The incidence of pseudothrombocytopenia in automatic blood analyzers. Haematologia (Budap) 2000; 30: 117-21.
  • 4. Holmes MB, Kabbani S, Watkins MW, Battle RW, Schneider DJ. Images in cardiovascular medicine. Abciximab-associated pseudothrombocytopenia. Circulation 2000; 101: 938-9.
  • 5. Bragagni G, Bianconcini G, Brogna R, Zoli G. \[Pseudothrombocytopenia: clinical comment on 37 cases]. Minerva Med 2001; 92: 13-7.
  • 6. Tomonari A, Hirai K, Aoki H, Mima N, Kashiwagi S, Masuda K, et al. \[Pure red cell aplasia and pseudothrombocytopenia associated with hepatitis A]. Rinsho Ketsueki 1991; 32: 147-51.
  • 7. Choe WH, Cho YU, Chae JD, Kim SH. Pseudothrombocytopenia or platelet clumping as a possible cause of low platelet count in patients with viral infection: a case series from single institution focusing on hepatitis A virus infection. Int J Lab Hematol 2013; 35: 70-6.
  • 8. Akıncı B, Akarsu M, Yener S, Saygılı F, Özcan MA, Akpınar H. Edta induced pseudothrombocytopenia in a patient with hepatitis a infection. DEU Journal of Medical Faculty 2005; 19: 50-4.
Toplam 8 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Bulaşıcı Hastalıkları
Bölüm Olgu Sunumu
Yazarlar

Zafer Bıçakçı

Yayımlanma Tarihi 30 Nisan 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 19 Sayı: 1

Kaynak Göster

EndNote Bıçakçı Z (01 Nisan 2018) Pseudothrombocytopenia in Case of Acute Viral Hepatitis A. Meandros Medical And Dental Journal 19 1 79–81.