Platelets clumping but down in number??

I've been to the hospital today and they were pleased with the results, my platelets were down to 400 (hurray!) However I always take a picture of the results to look at at home, before I hand them in with the prescription at the pharmacy, and I've just noticed under the platelet result it says:

"Analyser has detected platelet clumping during analysis, therefore results may be unreliable"

I didn't notice this at the hospital otherwise I would have asked about it, and the specialist nurse I saw didn't mention it - she just said everything was ok and come back in 12 weeks.

Should I be worried about this? Are they clumping in my veins too?

My other results are pretty near normal too.

They did have a lot of trouble getting blood from me today, they always do I seem to have weak hidden veins! Eventually they got some from my hands as usual. They tried my arms a few times before they had to send out to a ward for some of the "butterflys" they use on hands, they ended up using 3 of these before they got some blood. They no longer have them in the clinic as they are more expensive than the normal ones!

Thanks for advice in advance

Lizzie

17 Replies

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  • Hi lizzieep,

    I've not had this happen to me but googled it and found this explanation on another health unlocked site.

    "The way I understand it is that when a blood test is done a chemical is routinely used in the test tube on the blood sample. The chemical used in most cases is EDTA (Ethylenediaminetetraacetic acid. Sometimes platelets clump in the test tube when EDTA is used.

    The blood sample can be tested using a different chemical to get a platelet count if EDTA produces CLUMPING PLATELETS. So when I subsequently had yet another blood test on February 24th I had 3 samples taken, one to be tested with EDTA, the second to be tested in CITRATE (an alternative chemical) and thirdly another to be tested using Lithium Heparin (yet another chemical). The results came back satisfactory this time with a platelet count of 139 and amazingly they did NOT CLUMP this time in the EDTA."

    Maybe it's worth a call to your specialist nurse just to clarify.

    Best wishes

    Judy x

  • Thank you, I feel a bit easier now! However I think I will try and get in touch with her to clarify what it says. She didn't mention it , and if it was important I presume she would have!

    Kind regards

    Lizzie x

  • Yes, I think maybe if your platelets were really low then they may have tested you again. Very interesting though, I didn't even realise the blood was mixed with something to test!

    Judy x

  • Neither did I - we live and learn! xx

  • Hi Lizzie , good news on your results . ido t know anything about clumping myself , Im told mt platets are large , this blood malarky is all very complex eh , At least the Drs are not concerned ,hence leaving you for 12 week ,take care best wishes Holly x

  • Thank you for replying, I'm hoping she would have said something if it was important!

    Kind regards

    Lizzie x

  • I had exactly the same at my last clinic but my heam has asked for a citrate blood sample to be taken ( the blue top ) he explained that it could be a lab thing but it can give a false low reading of platelets .

    I have tiny veins and it takes ages to get the blood which can also cause clumping .

    Hope that helps xx

  • Thank you! I feel a bit better about it but I know I'll have it on my mind until I ave the haem can reassure me!

    Lizzie x

  • Hi Lizzie, I would phone your specialist nurse and ask for an explanation, even if it's just to relieve any anxiety this has caused you. It's a long wait in between appointments! I for one would be very interested in the response you get. Keep us updated.

    Mary x

  • Hey Lizzie... :)

    I believe that everyone has mostly already covered this one for you in any event... but... I also suffer from very poor veins, and as a result sometimes the blood is what they refer to as 'Hemolyzed'

    Understanding the Hemolyzed Blood Test Results

    Medical Articles and Infographics, Mar 24, 2015

    Was a blood test recently ordered for you? When the results came back, did the doctor tell you that your test had been hemolyzed? When lab reports indicate that a blood specimen has been hemolyzed, then this is an indication that the red blood cells in that sample were destroyed in some way. The destruction of the red blood cells will release hemoglobin and this renders the sample useless.

    When a hemolyzed blood test is the result, most doctors will order another blood draw so that the test can be accurately completed. Not all test results are affected by hemoglobin, however, so if you did get your results back and it was noted that the blood test was hemolyzed, then there is nothing to worry about at all.

    What Leads To a Blood Test Becoming Hemolyzed?

    Most of the time, a hemolyzed blood test occurs because of a provider not following best practices while taking the blood draw. The most common reason for this test result is the presence of too great a vacuum in the vein when the needle is inserted. This causes the red blood cells to be drawn to the opening too quickly.

    Here are some of the other common reasons for a blood test result to come back in this way.

    1. The wrong needle is used.

    If the red blood cells are forced through an opening that is too small for them, then the result will be their destruction. This, in turn, causes the hemoglobin to be released.

    2. The wrong tube is used.

    Having a tube that is too large for the sample being drawn can also cause this problem. This is due to the added vacuum capacity that the large space can create during the blood draw. Having a tube that is too small can also cause this problem because the red blood cells become too compressed.

    3. The draw happens too slowly.

    If the technician draws the blood in too slowly, this may also cause a hemolyzed test result.

    4. The blood sample is shaken.

    Just the simple act of vigorously shaking the blood sample is enough to cause the destruction of the red blood cells that it contains.

    Laboratory procedures may also cause a hemolyzed blood test. This tends to happen when a anticoagulated blood sample is run through a centrifuge.

    Sometimes Patient Actions Can Also Cause a Hemolyzed Sample

    How the blood draw occurs has a direct impact on whether or not the blood sample will become hemolyzed. If a patient has their fist clenched for too long, then there is a slight risk for the blood draw to be compromised. This may also occur if the tourniquet is held in place for too long. A best practice is to have the tourniquet on for no longer than a minute and to only clench a fist when necessary to facilitate obtaining the sample.

    How blood samples are transported to the laboratory can also affect the test results that are obtained. If the blood sample gets too hot or too cold, the red blood cell membranes may become unsustainable and rupture, ruining the sample.

    How the blood sample is processed may also cause it to become hemolyzed. When applicator sticks are used improperly to dislodge fibrin while testing, the end result may be the accidental rupture of the red blood cells it contains. Having too long of a contact with the plasma or serum used for testing may also cause the membranes to rupture. Even processing the sample too quickly has been known to cause a hemolyzed result.

    What Are the Options That Are Available?

    The most common reaction to a hemolyzed blood test result is to take another blood sample. A different location may be chosen and the technician taking the sample may try using a different needle gauge to lessen the risks of a second occurrence.

    When all of the blood collection assemblies are not properly fitted and frothing occurs, there will be an increased risk of experiencing a hemolyzed blood test. A greater focus on the timing of activators and other materials used with the test will also be in place.

    From the patient perspective, there is really just one thing to do: relax as best as possible. Make sure the arm isnโ€™t tense and rigid and avoid flinching when the needle is inserted.

    A hemolyzed blood test does not mean there is something wrong with a patient. It just means that there was a problem involved at one point in the testing chain and this causes the membranes of the red blood cells to be destroyed. You may wish, however, to discuss with your health provider about who will be responsible for payment of the second blood draw?

    Best wishes Lizzie... :)

    Steve

    (Sydney)

  • Thank you for that information. I've never thought about what happens to the samples that are taken! I have my blood taken and then see the doctor or specialist nurse about 45 minutes later so the samples are rushed to the lab and analysed quickly.

    They had a lot of problems taking my blood yesterday so that may have caused the problem.

    Best w

    Lizzie

  • I sometimes get "clumped platelets" and told it is to do with a slightly abnormal shape and size making them "sticky", especially after a venesection when I make a lot of platelets quickly. Apparently this does lead to a higher risk of a clot - I was told to make sure I took my aspirin.

    But u may have clumping from many other reasons as other people posting have noted.

  • Thank you!

    Lizzie x

  • Hi Lizzie I see you have a very comprehensive response to your question already, I have learnt something, I've never heard of clumping platelets. The only thing I would add to your replies is that I've always had blood taken from my left arm but noticed it was becoming more painful and bruised, I mentioned it to the plebotomist. She explained that the veins begin to collapse the more they are use, and unfortunately don't recover, so it becomes more painful to have blood taken from them. The last two times I've had it taken from my right arm but I'm expecting this to probably become more problematic over the coming years. I was only diagnosed with ET 18 months ago so at 67 I'm hoping I have several more years of this blood taking, I'm trying not to think about it too much.

  • Hi Linda, I've always had trouble with blood taking, I used to donate blood when I was younger but eventually they said my veins were too deep and weak and not to go anymore! I do worry what would happen if I needed some putting in ๐Ÿ˜ณ๐Ÿ˜ณ

    I'm 64 soon so, like you, hope that I have many more years of having it taken!

    Best wishes

    Lizzie

  • Hi its always best to swap your arm each time when having a blood test, that way one arm doesn't get used all the time x

  • Hi Lizzie, thats good news in one sense and good you haven't got to be seen for 12 weeks x

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