Customize Consent Preferences

We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below.

The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. ... 

Always Active

Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data.

No cookies to display.

Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features.

No cookies to display.

Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc.

No cookies to display.

Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

No cookies to display.

Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns.

No cookies to display.

MM250602: Platelet Satellitism

Blood film showing platelets clustering around neutrophils.

This week’s Morphology Monday case featured a fascinating artefact, platelet satellitism, where platelets appear to “cluster” around white blood cells, particularly neutrophils though it has also been reported around other white cells as well.

Platelet satellitism is an in vitro phenomenon in which platelets surround and stick to neutrophils in a rosette-like fashion on a peripheral blood smear. It’s not a sign of disease but rather an artefact linked to the anticoagulant EDTA used in blood collection tubes. In automated analysers, platelet satellitism can cause a falsely low platelet count (pseudothrombocytopaenia), potentially leading to unnecessary investigations or clinical concern.

The exact mechanism isn’t fully understood, but it’s thought to be due to:

  • EDTA-dependent IgG autoantibodies
  • These antibodies bind platelets to Fcγ receptors on neutrophils, forming rosettes on the film
  • This occurs only in EDTA-anticoagulated blood and not in samples collected in citrate or heparin

If platelet satellitism is suspected:

  • Repeat the sample in a citrate tube
  • Confirm true platelet count with a manual film review
  • Communicate with clinicians to avoid unnecessary intervention

This case highlights why morphology remains essential — even when automation does most of the counting.

_____
Special thanks to Charlotte Pattison for sharing the images for this case.

Leave a Reply

Your email address will not be published. Required fields are marked *