Platelet Clumping in Sodium Citrate

Here is a reprise of a Fritsma Factor post that appeared a few years ago:

Here is a question on platelet clumping or satellitosis in citrate tubes from Georgina Gibbons at Summit Health.

Do you have any information on patients that have platelet clumping in both the EDTA and sodium citrate tubes? We have found on occasion that these people may have no clumping in sodium heparin green tops. Have you read or heard anything similar to this?

Hi, Georgina. I don’t have any references but have used sodium or lithium heparin for patients whose platelets clump or satellite in EDTA or sodium citrate. In one instance, however, I found the platelets clumped even in heparin, generating a platelet count of < 50,000/uL in a healthy male. For him, we collected a manual platelet count and blood film from a capillary puncture, which worked well. Geo