Prathiba Balai Kerishnan, Hospital Slim River, Malaysia

Prathiba Balai Kerishnan

Hospital Slim River, Malaysia

Presentation Title:

The curious case of spurious thrombocytosis

Abstract

Introduction: Spurious thrombocytosis is a rare cause of thrombocytosis which may occur due to presence of red cell fragments, inclusion bodies, haemolysis, burns or cryoglobulinemia. Modern haematology analyzers enable initially high platelet counts to be rechecked by utilizing different methods to verify results prior to validation. Platelets can now be measured by impedance, optical and fluorescence methods. 
Case presentation: 39 years old female, with history of multiple admissions, mainly for obstetric issues. First presentation in 2014 with symptomatic anaemia and incidental finding of thrombocytosis and splenomegaly. FBC upon first admission: Hb: 8.6g/dl, MCV: 50.5fl, MCH: 16.1pg, Platelet ++++ (unrecordable), WBC: 10.5x103/uL. FBP reported as thalassaemia/ haemoglobinopathy with normal platelet morphology while Hb analysis showed Beta thalassaemia trait. CRP and ESR were elevated with normal iron profile. Autoimmune screening and tumor markers were negative. Molecular analysis JAK2V617F not detected. Bone marrow examination not performed. Throughout admissions (from 2014 to 2021), platelet counts were constantly raised with highest reported 2829x103/uL. PLT-O however, were normal, ranging between 300 to 400x103/uL. Presence of red cell fragments due to underlying thalassaemia was attributed to the false thrombocytosis. 
Discussion: This case highlights the importance of utilizing newer platelet counting technology for accurate counts to avoid unnecessary, expensive and potentially invasive further tests. Role of laboratory personnel is crucial to recognize histogram, scatter plots, flags and perform reflex testing when necessary to deliver accurate results.

Biography

Prathiba Balai Kerishnan has completed Bachelor of Medical Laboratory Sciences (Hons). She started her education journey by pursuing Diploma in Medical Laboratory Sciences in College of Medical Laboratory Technologist under Malaysian Ministry of  Health. She further pursued Advance Diploma in Hematology majoring in Red and White Blood Cell Disorders as well as Hemostasis & Thrombosis under the same college. She has 15 years of working experience and is currently serving as a Senior Medical Laboratory Technologist in Hematology Department in the Slim River Hospital in Perak state, Malaysia. Being actively involved in national and state level clinical research, she was selected as one of the poster presenter in National Pathology Conference 2025, 2023 and oral presenter at the state level. She was also been invited as the oral presenter in the 2nd International Conference Primary Care and Public Healthcare year 2023. Been invited as a speaker for University student for a workshop title “Blood cell morphology” year 2023, she  also active involving in oral presentation, presented webinar entitled “Bone marrow laboratory investigations” under Medical Laboratory Technologist Society year 2024.