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Case Report

Open Access

Massive RBC fragmentation masks severe thrombocytopenia in both impedance and optical platelet count measurements – a case report of a neonate on ECMO support


1Department of Laboratory Diagnostics, University Hospital Zagreb

DOI: 10.22514/SV121.102016.24 Vol.12,Issue S1,October 2016 pp.128-130

Published: 10 October 2016

*Corresponding Author(s): ANA MLINARIĆ E-mail:


Extracorporeal membranous oxygenation (ECMO) is a life-saving treatment for pae-diatric patients with cardiac or respiratory failure of diverse aetiology. ECMO sup-port is implemented only when all other available medications and procedures fail to treat the underlying cause of organ fail-ure. The reason for caution is a high risk of complications, including intravascular haemolysis, bleeding or clot formation, inflammation and sepsis. Platelet count is closely monitored in assessment of bleed-ing risk associated with ECMO support. Platelets are counted as a parameter of the complete blood count and can be measured using impedance or optical technology. We report a case of severe red blood cell (RBC) fragmentation in a neonate on ECMO in whom erroneously normal platelet counts were obtained by all available automated methods for platelet count in an emergen-cy laboratory. Based on those observations we have implemented an additional proce-dure for recognising interferences of frag-mented and microcytic RBCs that cause spuriously normal platelet counts.


platelet count, ECMO, frag-mented RBC, neonates, analytical interfer-ence

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ANA MLINARIĆ,GORDANA FRESSL JUROŠ,DUNJA ROGIĆ. Massive RBC fragmentation masks severe thrombocytopenia in both impedance and optical platelet count measurements – a case report of a neonate on ECMO support. Signa Vitae. 2016. 12(S1);128-130.


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