Arch Hellen Med, 34(1), January-February 2017, 86-90
Reversal of platelet aggregation by supplementation with amikacin in vitro
V. Konstantinidou,1 E. Vagdatli,2 F. Eleftheriou,1 A. Tsikopoulos,3 A. Seremetidou,1 F. Doutsaridou,1 A. Zouridaki1
OBJECTIVE One of the major causes of pseudothrombocytopenia is platelet clumping due to faulty phlebotomy technique. Platelet clumps caused by ethylenediaminetetraacetic acid (EDTA) pseudothrombocytopenia have been reported to be dissolved by aminoglycosides. This study investigated whether platelet clumps caused by flawed phlebotomy practice can be dissolved in vitro by the addition of amikacin.
METHOD In 66 blood samples, the platelets were counted using a hematology analyzer. Platelet clumping was then provoked by the addition of calcium chloride (CaCl2) and confirmed by microscopic observation of blood smears. To each sample, 20 mg/mL of amikacin was added, and the platelets were recounted after 2 and 6 hours. The platelet count of each sample was also estimated by microscopic observation of blood smears.
RESULTS Two hours after supplementation with amikacin, the platelet count had increased significantly (p<0.001) compared to that immediately after the formation of clumps. Six hours after the addition of amikacin a further significant increase in platelet count was observed (p<0.001). In 90% of the blood samples, the platelet increase was greater than 50% of the initial value. The rise was gradual and ranged from 23 to 100%, with a mean of 86%. Microscopic observation of blood smears revealed partial or complete dissolution of platelet aggregates.
CONCLUSIONS The addition of amikacin to an EDTA blood sample can achieve the partial or complete dissolution of platelet clumps caused by faulty phlebotomy practice, enabling a better approximate estimate of the real platelet count.
Key words: Amikacin, Phlebotomy, Platelet aggregation, Platelet count, Platelets.