Platelets are formed in the bone marrow along with other blood components such as the red blood cells and white blood cells. Platelets, also called thrombocytes, are small cell fragments that help in the blood clotting process. This clotting activity is a normal body function necessary to stop bleeding.
Platelets along with many other proteins such as fibrin contribute to the success of the entire clotting system. There are many steps involved in blood clotting, all of which start with an injury or bleeding. Different proteins together with the platelets concerned interplay a series of actions that ultimately result in the formation of a clot.
Diagnostic procedures in detecting abnormal platelet count
1. Blood smear.
A blood smear is a laboratory procedure that involves having a drop of blood collected from the patient’s veins smeared on a slide to create homogenous distribution of blood film.
It will be examined under a microscope for unusual shapes and sizes. Platelets become visible as small dot-like structures which can be roughly numbered to identify any abnormally high or low count.
The method also gives the opportunity to look at the morphology of the platelets which is an important factor in diagnosing any disease that can be related to platelets.
This is the simplest method to count platelets. It is done by taking a sample of blood from the veins and making a smear of blood on a special slide. The slide is then examined under a microscope where an estimate of the cell count is made.
All types of blood cells can be counted with this method. The procedure may simply give a rough estimate of the person’s platelet count but enough to detect an abnormal count.
One great advantage using this method is that the morphology of cells can also be seen through the microscope. It is a long and painstaking procedure that makes it mostly done away with the advent of new and faster technologies.
3. Cell counter.
A coulter counter is a sophisticated piece of equipment that can be used to count platelets rapidly. A sample of blood from the veins is taken and passed through electrical impedence.
The electrical impedence is a kind of resistance applied to the path of cells. Since different cells differ in their properties, they are separated out from one to another.
The platelets will also be separated and counted by the automated machine. This machine can give platelet count results in just a few minutes after putting the sample in.
PFA-100 is a relatively new diagnostic procedure to detect abnormal platelet count. It can help detect platelet dependent coagulation under lab conditions and gives a rough estimate on platelet levels of the body.
Compared to older techniques of detecting coagulation, such as bleeding time and clotting time, where the coagulation process is observed and performed by creating a cut on the skin of a person (intentional source of bleeding) with a surgical instrument, new approaches like PFA-100 is more preferable.
These old techniques that involve intentional cutting of the patient’s skin to allow for bleeding is actually considered brutal practice which has now made it mostly discontinued in many institutions.
In PFA-100, the blood sample is simply collected with a needle and a syringe. The rest of the test is conducted in a lab. It gives a better estimate of patient bleeding and clotting tendencies without the need for cutting.
5. Bone marrow examination.
The bone marrow can become accessible for examination under a microscope or cell counter through specialized needles called bone marrow aspiration and biopsy needles.
The needles used are long enough to reach the bone marrow after penetrating the skin, fat, muscle and the bone in that order. The collected bone marrow looks just like blood, only fresh and has to be prepared immediately for examination.
The slides and the marrow itself can be used to measure platelet levels and estimate platelet function.
6. Radiolabeled ELISA
It is a diagnostic procedure performed to detect abnormal platelet count where antibodies are used to detect the presence of any substance.
The antibodies are made against a specific platelet antigen. The antibody is radiolabelled and can be easily detected with radio scanners that give an exact count of the sample.
The count is used to estimate if there are any abnormality in the number of platelets of the person.
7. Prothrombin time (PT)
Prothrombin time is the time it takes for the formation of prothrombin. Prothrombin is a protein required in the formation of blood clots.
The test gives an estimate on the coagulation or bleeding tendency of the body in conjunction with the clotting factor’s availability. If the results comes prolonged, it suggests that a bleeding tendency is present in the body.
8. Activated partial thromboplastin time (aPTT)
Activated partial thromboplastin time is the duration taken in the formation of activated partial thromboplastin. It is another protein that is involved in the clotting cycle.
It shows the time it takes for a sample of blood to clot naturally. It gives an estimate on bleeding and clotting tendencies.
9. Partial thromboplastin time with kaolin (PTTk)
This is another test that differentiates a clotting disorder from a bleeding disorder. It is used in conjunction with PT and INR.
10. International normalized ratio (INR)
International normalized ratio is a technique that uses a calculation which is dependent on the prothrombin time of the patient and standardised prothrombin time in a lab. This is used to standardize results across different laboratories worldwide as recommended by a World Health Organization (WHO) committee. The calculation gives an estimate of the coagulation or bleeding tendencies of the body. INR should be only applicable for individuals who are receiving the anticoagulant warfarin.
The last four tests do not give an exact counting of platelets but are used in conjunction with other tests to measure the bleeding or clotting tendency of the body. This gives a clue towards the diagnosis of a disease. Once the diagnosis is made, the disease can be treated as appropriate. Check out uses of blood platelets in patients.
It will be a really horrible situation to experience sudden and uncontrolled gushing out of blood from the nose, gums and other openings of the body. And sadly, it could happen with a really low platelet count. Before that happens, better manage it immediately. This may usually be a costly endeavor but there are affordable options such as all-natural remedies you can learn from money back guaranteed materials like Conquer Low Platelets.
All of the above mentioned tests are performed after a medical history check of the patient accompanied by some physical examination by the physician. These two steps mark the most important factors in directing the physician for a diagnosis.
The physician then uses the diagnostic procedures to detect abnormalities and rule out any possibilities that may be suspected during the history taking and examination process.
All of the above mentioned tests may not be done simultaneously; but will certainly be significant procedures in the management of abnormal platelets. Usage depends on the most appropriate method with regards to findings.
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