What can cause an automated platelet count to be falsely low?

An automated platelet count may be falsely low due to phenomena such as platelet satellitism and platelet clumping.

Platelet satellitism occurs when platelets surround and adhere to white blood cells, forming an abnormal morphology that can lead to inaccurate counting by automated analyzers. When platelets aggregate in this manner, it can create clusters that the analyzer misinterprets, resulting in a lower than actual platelet count.

Similarly, platelet clumping is when platelets clump together either due to sample handling, specific anticoagulants, or other factors, leading to the same miscounting issue. Clumped platelets may be counted as single units, resulting in a significant underestimation of the platelet population.

Both of these conditions highlight the importance of careful sample handling and consideration of the patient's history and clinical situation when interpreting platelet counts, ensuring accurate readings, and diagnosing potential hematological conditions.