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Platelet Clumping in Sodium Citrate: Reprise

From Kathy Jacobs at Chronolog, Inc.

Hi George, When a patient’s platelets clump in sodium citrate, is there another anticoagulant that can be used to allow LTA platelet aggregation testing? Thanx in advance, Kathy.

Hi, Kathy, good to “hear” from you. You posted your question originally as a comment to a 2007 post, so I decided to bring it to the top to ensure everyone sees it. On two occasions I’ve used heparinized specimens for CBCs when EDTA and citrate specimens exhibited clumping and satellitosis, however, I doubt this would work for light transmittance (LTA) or for impedance aggregometry. I’m guessing your client has probably already tried heparin, anyway. I’ve heard of people mildly vortexing a sample with slight clumping, but, again, that probably would just activate or destroy the platelets. Beyond that, I don’t really have a solution, but let’s hope that one of our blog participants has come up with something. I’d be curious to learn about the patient’s condition, is it satellitosis, or hyperaggregable platelets? Geo

Comments (2)
Platelet Function Testing
Jul 19, 2012 12:01am

Hi George,
What we do in this situation is draw the sodium

Hi George,
What we do in this situation is draw the sodium citrate tube and have the phlebotomist put a heel warmer around it to keep it warm and run it to the lab and then perform the test STAT. This seems to decrease the clumping in the sodium citrate tube. Richard

Dr. Wakileh
Jun 28, 2012 1:01am

Hi George,
Regarding the LTA; were kryoglobulins and kryofi

Hi George,
Regarding the LTA; were kryoglobulins and kryofibrinogens ruled out? Transport at 37° may be of help. For CBCs and clumping with EDTA and citrate specimens (pseudothrombocytopenia) we typically use the Sarstedt Thromboexakt-Monovetten in German uniclinics.
Michael Wakileh
Universitätsklinik Rostock

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