Platelet count

To

Objectives

understand the importance of doing a

platelet count
To know the methods of performing a
platelet count .
To perform a platelet count .
Know the possible sources of error and
precautions to be taken in conducting a
platelet count.
Know the normal values.
Know the possible causes of abnormal
platelet counts.

What is a platelet
count?

Why is it done?

Bleeding-petechiae

Functions of platelets

Why is platelet counting

difficult?

They are small and difficult to discern.

Their adhesive character-attach readily to
glassware, particles or debris in the diluting
fluid.
They clump easily.
Not evenly distributed in the mixture of blood
and diluting fluid.
They readily disintegrate in the blood diluted
with fluid making it difficult to distinguish
them from debris.
Therefore unless carefully done ,accurate
counting of platelets becomes impossible.

Methods
Haemocytometry

(direct count)
1.Brecher-Cronkite method
2.Rees Ecker method
Study of blood smear (indirect
method)
Automated counting.

Brecher Cronkite method

Principle:
The diluent contains Ammonium Oxalate.
This completely lyses the red cells.
the platelets are then counted with a
phase haemocytometer and phase
contrast microscope to enhance the
refractileness of the platelets.(or
ordinary microscope)
Advantage:
Identification is easier.
The error involved is low

Technique

Platelets as seen on
blood smears

Calculation

Sources of error

Precautions to be taken

Glassware must be scrupulously cleaned .

debris and dust are the main sources of error
as they are easily mistaken for platelets.
The diluting fluid must be filtered just before
use .
to remove particles.
If venous blood is used the platelets must be
counted within 3 hours.
delay causes disintegration and clumping of
platelets.
Blood should be rapidly diluted .
this is essential to prevent clumping.

Precautions to be taken

Blood must be thoroughly mixed with the

diluent by shaking the contents at least for 10
minutes.
inadequate mixing results in clumping of
platelets.
The charged chamber should be kept for 15
minutes under petri dish.
to prevent evaporation and for the cells to
settle down.
If other haematologic tests are to be done with
platelet count ,and blood is used from the same
puncture ,take blood for the platelet count first.
The finger should not be squeezed excessively
to collect blood .

Conditions affecting number of

platelets in blood

Thrombocytopenia

low platelet count

Thrombocytosis
high platelet count

Thrombocytopenia
(low platelet count)
Causes
Reduced production of platelets
Increased breakdown of platelets
Trapping of platelets in the
spleen

Thrombocytopenia (low platelet

count)
As a result of
a bone marrow disorder such as
leukemia
an immune system malfunction
as a reaction to a medication.
Complications may range from none at
all to severe bleeding.
The greatest risk is when platelet
count falls very low <10,000 per
microliter . internal bleeding may occur
despite a lack of any injury.

Reduced production of
platelets
leukemia
some

types of anemia,
Viral infections,
cancers that affect bone marrow,
chemotherapy drugs
heavy alcohol consumption

Trm1s 7_3.s wf

Increased breakdown of
platelets

Pregnancy
Idiopathic thrombocytopenic purpura
(ITP),
Other autoimmune diseases, such as
lupus and rheumatoid arthritis,
Septicemia severe bacterial infections,
Thrombotic thrombocytopenic
purpura (TTP), a rare, life-threatening
condition TTP can happen sporadically or
as a side effect of some medications.
Hemolytic uremic syndrome,
Dengue fever

Trapping of platelets in the

spleen
may

harbor too many platelets,

causing a decrease in the number of
platelets in circulation.

Signs and symptoms of a low blood

platelet count may include:

Easy or excessive bruising

Superficial bleeding into the
skin that appears as a rash
of pinpoint-sized reddishpurple spots (petechiae),
usually on the lower legs
Prolonged bleeding from
cuts
Spontaneous bleeding from
gums or nose
Blood in urine or stools
Unusually heavy menstrual
flows
Profuse bleeding during
surgery
Serious or widespread
bleeding indicates an
emergency and requires
immediate care.

Thrombocytosis
(high platelet levels )
reaction

to an infection

surgery
certain medications
Polycythemia vera, in which the
bone marrow produces too many
platelets too quickly.

Questions

Why does the platelet count give inaccurate

results unless performed carefully?
What are the different methods of platelet
count?
What is the principle of the Brecher
Cronkite method?
Why is the reagent filtered before every use?
Why is venous blood preferred to capillary
blood for platelet count?
Why is glassware cleaned thoroughly for
platelet count?

Questions

Why is the blood rapidly diluted and thoroughly

mixed with the diluting fluid?
Why is the charged chamber covered by a
petridish for 15 minutes?
How do you identify platelets under the high
power objective?
What are the sources of error in manual method
of platelet count?
What is the normal platelet count?
What are the properties of platelets?what are
their functions?
What are the causes of thrombocytosis and
thrombocytopenia?

Happy counting!