EDTA-induced pseudothrombocytosis and citrate-induced platelet agglutination in a patient with Waldenstrom macroglobulinemia

Hematology analyzers sometimes generate spurious results. A patient had EDTA-induced pseudothrombocytosis and platelet agglutination in citrate blood samples. This case verifies that addition of 1% paraformaldehyde to the citrate tubes can prevent platelet clumping. Further, it illustrates the advantages of having access to more than one platelet count method.