# Neutrophil Aggregation in a Relapsed Case of Idiopathic Thrombocytopenic Purpura: A Case Report

## TL;DR

A 67-year-old man with a relapsed blood disorder showed misleading lab results due to in vitro changes in neutrophils and platelets.

## Contribution

The report highlights pseudo-neutropenia and pseudo-thrombocytopenia in a relapsed ITP case, emphasizing the role of in vitro factors like EDTA and cold agglutinins.

## Key findings

- The patient exhibited pseudo-neutropenia and pseudo-thrombocytopenia due to in vitro changes.
- Cold agglutination and EDTA-induced alterations were identified as contributing factors.
- The findings underscore the importance of recognizing spurious lab results in clinical practice.

## Abstract

This case report highlights a rare instance of pseudo-neutropenia involving in vitro alterations in neutrophils in a 67-year-old male with relapsed idiopathic thrombocytopenic purpura (ITP). Pseudo-neutropenia, also known as spurious neutropenia, refers to in vitro changes in neutrophil counts that do not accurately reflect the patient’s clinical condition. This patient also exhibited pseudo-thrombocytopenia and cold agglutination in vitro. This phenomenon is often induced by the anticoagulant ethylenediaminetetraacetic acid (EDTA) or the presence of cold agglutinins or combined with a medication reaction.