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Case Reports
. 2023 Nov 21;11(11):e8153.
doi: 10.1002/ccr3.8153. eCollection 2023 Nov.

Transient EDTA-dependent pseudothrombocytopenia and ulcerative colitis recurrence during chemotherapy: A case of misleading platelet count results attributable to a laboratory artifact

Ayako Watanabe  1   2 , Hirokazu Toshima  3 , Misa Saeki  1   2 , Takuya Nagata  1   2 , Tatsuo Koyanagi  4 , Masumi Minamizawa  4 , Yuka Kashiwabara  1   2 , Koji Kobayashi  3 , Ken Shimada  3 , Kenji Momo  2
Affiliations
Case Reports

Transient EDTA-dependent pseudothrombocytopenia and ulcerative colitis recurrence during chemotherapy: A case of misleading platelet count results attributable to a laboratory artifact

Ayako Watanabe et al. Clin Case Rep. .

Abstract

Key clinical message: EDTA-dependent pseudothrombocytopenia as well as myelosuppression should be suspected when thrombocytopenia occurs in patients with autoimmune disease during chemotherapy.

Abstract: A patient with pancreatic cancer and ulcerative colitis developed transient ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia with exacerbation of ulcerative colitis during chemotherapy. Unfortunately, pseudothrombocytopenia could not be immediately detected because thrombocytopenia was masked by a reasonable time course of adverse events associated with chemotherapy and ulcerative colitis recurrence. When thrombocytopenia occurs during chemotherapy, especially in patients with autoimmune diseases, EDTA-dependent pseudothrombocytopenia and bone marrow suppression caused by anti-cancer agents should be suspected.

Keywords: autoimmune disease; delayed treatment; laboratory artifact; misleading diagnosis; transient EDTA‐dependent pseudothrombocytopenia.

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Conflict of interest statement

The Department of Hospital Pharmaceutics, School of Pharmacy, Showa University received funds from Ono for a contract research project according to a collaborative research agreement. Ken Shimada is medical adviser of Ono, Taiho, and Sawai. As a potential conflict of interest, Hospital Pharmaceutics received research grants from Daiichi Sankyo, Mochida, Shionogi, Ono, Taiho, Nippon–Kayaku, and Bayer. Takuya Nagata received an honorarium fee for presentations from Sanofi. Kenji Momo received an honorarium fee for presentations from Nippon–Kayaku, Eisai and Abbvie. Yuka Kashiwabara received an honorarium fee for presentations from Daiichi Sankyo. Hirokazu Toshima received an honorarium fee for presentations from Daiichi Sankyo, Taiho, Bristol–Myers. Ken Shimada received an honorarium fee for presentations from Daiichi Sankyo, Ono, Taiho, Yakult, Bristol–Myers. The other authors declare no conflict of interest associated with this manuscript.

Figures

FIGURE 1
FIGURE 1
Clinical course of the present case.
FIGURE 2
FIGURE 2
Changes in the platelet count after the addition of ethylenediaminetetraacetic acid (EDTA).
FIGURE 3
FIGURE 3
A peripheral smear during thrombocytopenia.
See this image and copyright information in PMC

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