We have been getting patients referred to us for low platelet counts, and these are on the rise during dengue epidemics. Here are two cases.
Case 1: Ms. J, eight months pregnant
Ms. J was referred because her platelet count was reported as 20,000. We found that her platelets were reacting to the EDTA chemical in the blood collection tube and clumping together. The cell-counting machine reported this as a low count. When her blood was checked without EDTA, her platelet count was 2,00,000, completely normal.
Case 2: Baby D, six years old, with dengue
Baby D's platelets were reported as 18,000. It was the same phenomenon: the actual platelet count without EDTA was 2,30,000.
The bottom line
This is known as pseudothrombocytopenia: there is actually nothing wrong with the patient or their blood. A surprisingly low platelet count, especially without any bleeding, should be checked with a fresh sample and a microscope before any treatment is given.