Rarely amorphous blobs or globules may be seen on a peripheral blood smear.
(1) clumped platelets
(2) stain debris
Features of clumped platelets:
(1) granules present in the masses
(2) platelet count from automated analyzer reports thrombocytopenia
(3) often associated with EDTA anticoagulant, absent with citrate
(1) platelet and leukocyte counts normal
(2) dark granules, often with sharp edges
(3) absent in repeat smear stain in fresh, filtered stain
(1) leukocyte count from automated counter significantly higher than the estimate from the blood smear
(2) associated with cold (winter or refrigerated specimen); absent in repeat specimen collected in citrate and kept at 37°C
(3) presence of monoclonal proteins on serum protein electropheresis
(4) history of infection, autoimmune disease, lymphoproliferative disease
(1) abnormal thrombin time
(3) leukocyte count from automated counter significantly higher than the estimate from the blood smear
(4) history of autoimmune or malignant disease
Need to confirm: The presence of protein precipitates in specimens collected in heparin due to formation of heparin-protein complexes.
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Specialty: Hematology Oncology, Clinical Laboratory