MEANDROS MEDICAL AND DENTAL JOURNAL, cilt.19, sa.1, ss.79-81, 2018 (ESCI)
Pseudothrombocytopenia is a laboratory-based iatrogenic phenomenon. Pseudothrombocytopenia is not important in terms of bleeding and does not require transfusion of thrombocytopenia. If not identified at the early stages, pseudothrombocytopenia can lead to patients undergoing unnecessary investigations and overtreatment. Here we present a childhood case of pseudothrombocytopenia caused by hepatitis A virus (HAV) infection. A 9-year-old male was referred to our department for thrombocytopenia (thrombocyte count 70x10(9)/L). The liver was palpable 3-4 cm below the costal margin. Leukocyte count was 6.52x10(9)/L, hemoglobin 14.7 g/L, hematocrit 46.6%, thrombocyte count 58x10(9)/L. Aspartate transaminase 79.8 U/L, alanine transaminase 116.9 U/L, gamma-glutamyl transferase 156 U/L, alkaline phosphatase 1114 U/L, total bilirubin 0.98 mg/dL, and direct bilirubin 0.6 mg/dL. Other biochemistry values were normal. Anti HAV immunoglobulin M and immunoglobulin G were positive. The patient was diagnosed with hepatitis A. A peripheral smear revealed many thrombocyte clusters composed of 10-20 cells. HAV infection was thought to be the reason for pseudothrombocytopenia. The pseudocytopenia started to recover as the HAV infection got better and the thrombocyte count increased to over 150x10(9)/L at the end of a year. Peripheral smear evaluation is critical for accurate detection of thrombocytopenia and should be considered the initial step in cases with a familial or medical history of thrombocytopenia.