Lab Med Online.  2013 Oct;3(4):259-263.

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

Affiliations
  • 1Department of Laboratory Medicine, Wonkwang University, Sanbon Hospital, Gunpo, Korea. wooju67@paran.com

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 4degrees C, but not at 37degrees C; 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.

Keyword

Platelet satellitism; Platelet phagocytosis; Platelet-neutrophil agglutination

MeSH Terms

Agglutination
Blood Cells
Blood Platelets
Diagnostic Tests, Routine
Edetic Acid
Flank Pain
Korea
Monocytes
Neutrophils
Phagocytosis
Plasma
Edetic Acid

Figure

  • 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).


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