Platelets are tiny fragments of cells that can be found throughout every person’s blood stream.

The purpose for these fragments is to address and seal any breaks in blood vessels, such as tears, scrapes, and cuts.

This achieved through the clumping of platelets over the wound, preventing excessive loss of blood.

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Platelets are comprised of a sticky surface that has the ability to change shape and improve clumping effectiveness. The clumping of platelets, also known as blood clotting, can cause health-related problems and damage organs.

What are Platelets?

Just like other blood cells, platelets are produced inside our bones in our bone marrow. Blood cells are the product of larger cells known as megakaryocytes.

These larger cells are controlled by a hormone the liver produced called TPO, or thrombopoietin. In response to the presence of TPO within our blood, megakaryocytes break down into smaller fragments and release thousands of tiny platelets into the bloodstream.

Upon being released, these fragments bind to TPO and reduce TPO levels of production in the liver, therefore reducing platelet products.

Platelets themselves are not cells, they are small fragments of cells.

Because the surfaces of platelets are sticky, these fragments clump, or aggregate together when they come in contact with a rough surface, such as a damaged blood vessel.

Healthy Clumping

The blood vessels located within our bodies have a smooth surface. This surface is what allow our blood to freely flow without disruption.

When a person endures an injury involving a break in a blood vessel, the area that is exposed is comprised of a rough fibrous tissue.

Along the edges of a break, platelets begin to clump. They can also send out extensions and change shape to attract more platelet fragments that gather on the broken surface.

Eventually these fragments will gather enough platelets to create a seal across the broken vessel.

Red cells also assist in clumping by pushing the lighter platelet fragments towards the outside of the break.

Abnormal Clumping

Abnormal platelet clumping can be caused by health-related conditions. When this happens, cholesterol found in the blood will start to collect itself on each vessel’s smooth walls.

This action gives platelets a surface in which they can clump together unnecessarily. When blood supply is stopped by a blood vessel that is plugged, tissue damage results. Abnormal clumping can also be caused by excessive platelet production.

Caffeine and smoking, along with the consumption of foods high in triglycerides can increase the production of platelets beyond normal levels.

Pseudo-Thrombocytopenia: Platelet Clumping and Platelet Satellitism

Platelet clumping and platelet satellitism are two causes of pseudo-thrombocytopenia. The first report of platelet satellitism occurred in the 1960’s.

Platelet satellitism is a rare condition that occurs in the presence of ethylenediaminetetraacetic acid (EDTA) when lgG antibodies form.

EDTA is an anticoagulant used in the collection of hematology blood specimens.

When EDTA is introduced in the blood, the lgG antibody is then directed against the IIIa/IIIb glycoprotein complex located on the platelet membrane.

When the antibody begins to coat the platelets they rosette around specific segmented bands, neutrophils, and occasionally around monocytes.

Those that huddle around white blood cells aren’t counted by automated lab equipment, causing the platelet count in the blood to be falsely decreased. When lab technicians review a peripheral blood smear, it will be observed that platelets are attached to white blood cells.

Clumping of platelets will also occur in the presence of EDTA again, falsely decreasing the platelet count. In these types of cases, the specimen is reviewed and flagged by the blood smear analyzer to observe for giant platelets or platelet clumps.

If platelet clumping or platelet satellitism is observed on the peripheral smear, it is possible that the sample will be recollected using sodium citrate instead of EDTA as the anticoagulant.

Then, platelets can be reliably counted using the automated method.

A platelet count done from a tube comprised of liquid sodium citrate will need to be corrected due to the citrate’s dilutional effect.

This may be accomplished by multiplying the count obtained by the automated analyzer.

This phenomenon only occurs in 0.1% of the population. It can be associated with infections from trauma, thrombotic disorders, neoplastic diseases, autoimmune disorders, cytomegalovirus, rubella, and HIV. It is not always an indicator of platelet dysfunction or bleeding diathesis.

When an abnormally low platelet count is detected in the absence of a concerning medical history, the peripheral blood smear will undergo an examination and a fresh specimen will be obtained.

Prevention and Treatment

A popular prevention of an unannounced heart attack is aspirin. This medicine that is available over the counter blocks a specific step required for platelets to clump and stick together in the absence of an actual blood vessel break.

Aspirin, however, does not completely inhibit the clumping of platelets and runs the risk of causing abnormal bleeding.

Natural alternatives in the prevention and reduction of the abnormal clumping of platelets include grape seed extract, grape, fish oils, and vitamin E.

If you or a relative has been diagnosed with clumping platelets, talk to you doctor about the dangers and risks associated with this diagnosis, and what you can do to limit the dangers of unnecessary platelet clumping.

 

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