A Case of Platelet Satellitism with Platelet Phagocytosis by Neutrophils and Platelet-neutrophil Agglutination

Kui Hyun Yoon

doi:10.3343/lmo.2013.3.4.259

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Yoon: A Case of Platelet Satellitism with Platelet Phagocytosis by Neutrophils and Platelet-neutrophil Agglutination

Case Report

Diagnostic Hematology

Laboratory Medicine Online 2013; 3(4): 259-263.

Published online: 1 October 2013

DOI: https://doi.org/10.3343/lmo.2013.3.4.259

A Case of Platelet Satellitism with Platelet Phagocytosis by Neutrophils and Platelet-neutrophil Agglutination

Kui Hyun Yoon, M.D.

Department of Laboratory Medicine, Wonkwang University, Sanbon Hospital, Gunpo, Korea.

Corresponding author: Kui Hyun Yoon. Department of Laboratory Medicine, Wonkwang University, Sanbon Hospital, 321 Sanbon-ro, Gunpo 435-040, Korea. Tel: +82-31-390-2658, Fax: +82-31-391-2085, wooju67@paran.com

Received 19 April 2013 Revised 19 June 2013 Accepted 17 July 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Platelet satellitism is a rare phenomenon in which platelets adhere to the surface of neutrophils; in addition, platelet phagocytosis by neutrophils and monocytes is rare event. Although its clinical significance and pathophysiology are still unclear, platelet-neutrophil agglutination seems to be the end point of a process that is initiated by platelet satellitism and causes pseudothrombocytopenia and pseudoneutropenia. Differentiating pseudothrombocytopenia is essential to avoid unnecessary diagnostic testing and treatments. This report describes an unusual case of a 64 yr old man who presented with left flank pain and pseudothrombocytopenia, which was caused by platelet satellitism with platelet phagocytosis by neutrophils and platelet-neutrophil agglutination. Platelet satellitism occurred in the presence of ethylenediaminetetraacetic acid (EDTA) at room temperature or 4℃, but not at 37℃; however, platelet-neutrophil agglutination and pseudoleukopenia were observed in EDTA-treated blood only after a 2-hr incubation period at room temperature. Additionally, platelet satellitism could be induced in packed blood cells from a normal individual during a mixing assay with this patient's plasma. To the best of my knowledge, this is the first reported case of platelet satellitism with platelet phagocytosis by neutrophils and platelet-neutrophil agglutination in Korea.

Keywords: Platelet satellitism, Platelet phagocytosis, Platelet-neutrophil agglutination

Figures and Tables

Fig. 1

Peripheral blood smear of EDTA-anticoagulated blood showing (A) platelet satellitism and phagocytosis by neutrophils and (B) platelet- neutrophil agglutination (Wright stain, × 1,000).

Table 1

Complete blood and differential counts of EDTA-anticoagulated blood according to temperature and incubation time

Abbreviations: WBC, white blood cell; PLT, platelet; Neut, neutrophil; CBC, complete blood count; EDTA, ethylenediaminetetraacetic acid.

Table 2

Platelet-leukocyte association phenomenon scores of platelet satellitism induced by a mixing test after a 2-hr incubation at room temperature

Abbreviations: Pt, patient; NR, normal; EDTA, ethylenediaminetetraacetic acid; PLAP, platelet-leukocyte association phenomenon.

Notes

This article is available from http://www.labmedonline.org

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