Automated hematology analyzer often miss to count the platelet with abnormal size, particularly macro platelet. So every case should be examined manually to exclude macrothrombocythemia.
I am not Bio major but I can analyze data. Everywhere there outliers, we shall treat this as outlier.
When analyzers miss counting platelets with abnormal sizes, such as macroplatelets, perform a manual examination to exclude macrothrombocytopenia. Steps to handle outlier:
1. Visual Inspection: Prepare a peripheral blood smear slide and examine it under a microscope. Look for platelets with larger sizes compared to the normal range. Macroplatelets are usually identified by their increased diameter and irregular shapes.
2. Manual Counting: Select an area on the slide where platelets are well-distributed. Count the number of macroplatelets separately from the automated count. Use a counting grid or manual counting methods to ensure accuracy.
3. Calculate Corrected Platelet Count: Once you have obtained the manual count of macroplatelets, calculate the corrected platelet count. Subtract the number of macroplatelets from the total automated platelet count. The corrected platelet count reflects the number of normal-sized platelets.
4. Evaluate Clinical Significance: Assess the clinical significance of macrothrombocytopenia based on the patient's medical history, symptoms, and other laboratory findings. Macrothrombocytopenia can be associated with various conditions, including inherited disorders, immune-mediated disorders, or bone marrow abnormalities. Consult with a hematologist or appropriate specialist for further evaluation and interpretation.
5. Follow-up and Monitoring: If macrothrombocytopenia is confirmed, it is essential to monitor the patient closely. Additional investigations, such as genetic testing or bone marrow examination, may be necessary to determine the underlying cause. Regular follow-up and monitoring of platelet counts can help assess the progression of the condition and guide appropriate management.
For manual differentials, it is better to seek assistance from a qualified laboratory professional or hematologist to ensure accurate results and appropriate management of the patient.
Good luck