Comparative Analysis of Platelet Count Estimation by Peripheral Smear Method and Automated Hematology Analyser Method in Thrombocytopenic Patients

Aim: To estimate and correlate the platelet count by automated cell counter and manual method. Materials and Methods: The study was Prospective Cross- Sectional Study, carried out in the Department of Pathology, Adesh Medical College and Hospital Shahabad, Kurukshetra, on a group of 200 patients (125 males and 75 females) from 1st March to 31st May, 2024 in 3 months duration. All the obtained data were handled with confidentiality. Blood samples were collected from all age group by venipuncture in ethylene diamine tetra-acetic acid (EDTA) tubes following complete aseptic precautions. Smears will be prepared immediately and stained using Leishman’s stain following standard protocol. Platelets were counted in ten oil immersion fields and the count was multiplied by 15000 to obtain platelet count in lacs/mm3. The platelet count was also be determined by automated hematology analyzer. Results: We observed 63% of the patients were male and rest 37% were female with male: female of 1.7:1. Most of the patients belong to the age group of 30- 40 years i.e. 21%. The mean platelet count on automated analyzer was 67.5 ± 36.4 x103 /µL whereas the mean platelet count verified on peripheral smear was 106.1 ± 61.5 x 103/µL with a significant difference between the two groups (p-value <0.001). On manual examination, we observed that 23% of the patients which were previously diagnosed as thrombocytopenic on automation were found to be adequate in manual method i.e. pseudo-thrombocytopenia cases. We also evidenced that when examined on peripheral smear the actual platelet count was actually higher than automated count for most of the thrombocytopenic cases. Conclusion: In thrombocytopenic cases, verifying the platelet count generated by automated hematology analyzers through peripheral smear examination is imperative, particularly when abnormal platelet morphologies, such as giant platelets and platelet clumps are present. This confirmation is critical prior to initiating treatment, as it helps avoid unnecessary diagnostic procedures and inappropriate therapeutic interventions.