Case Report
Published: Sep 27, 2025 | DOI: 10.24911/ejmcr.9-2288
A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis
Authors:
Joris Godelaine
, Christine Van Laer
, Nancy Boeckx
, Mercedeh Tajdar
Article Info
Authors
Christine Van Laer
Department of Laboratory Medicine, University hospitals Leuven, Belgium.
Nancy Boeckx
Department of Laboratory Medicine, University hospitals Leuven, Belgium.
Mercedeh Tajdar
Department of Laboratory Medicine, University hospitals Leuven, Belgium.
Publication History
Received: July 17, 2025
Accepted: September 02, 2025
Published: September 27, 2025
Abstract
Background: Thrombophagocytosis refers to the phagocytosis of platelets by neutrophils or monocytes and is an uncommon finding, most often reported in bacterial infections. It may be linked to ethylenediaminetetraacetic acid (EDTA)-induced conformational changes in platelet membrane glycoproteins, which expose cryptantigens and promote immune-mediated interactions, resulting in platelet clumping, satellitism, and phagocytosis. If unrecognized, these in vitro artifacts can cause falsely low platelet counts, leading to pseudothrombocytopenia.
Case presentation: A 1-day-old neonate, born to a mother with a history of liver transplant on long-term immunosuppression, presented with normal initial blood values. However, the automated hematology analyzer flagged the sample, prompting microscopic review, which revealed thrombophagocytosis by neutrophils and, to a lesser extent, monocytes along with platelet satellitism. Repeat analysis of the same sample after 4 hours showed a marked decrease in platelet levels (160 × 10⁹/l to 88 × 10⁹/l), consistent with ongoing in vitro thrombophagocytosis. Maternal blood showed no abnormalities, and neither mother nor
neonate had signs of infection.
Conclusion: This case illustrates neonatal thrombophagocytosis in the absence of infection, suggesting the phenomenon is not exclusively infection-related. Our findings illustrate that delayed sample analysis can significantly lower platelet counts, risking misdiagnosis of thrombocytopenia. Awareness of EDTA-related artifacts is therefore essential for accurate laboratory interpretation and clinical decision-making.
Keywords: Thrombophagocytosis, pseudothrombocytopenia, platelet phagocytosis, case report
Pubmed Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar. A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis. EJMCR. 2025; 27 (September 2025): -. doi:10.24911/ejmcr.9-2288
Web Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar. A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis. https://www.ejmcr.com/articles/2288 [Access: September 29, 2025]. doi:10.24911/ejmcr.9-2288
AMA (American Medical Association) Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar. A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis. EJMCR. 2025; 27 (September 2025): -. doi:10.24911/ejmcr.9-2288
Vancouver/ICMJE Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar. A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis. EJMCR. (2025), [cited September 29, 2025]; 27 (September 2025): -. doi:10.24911/ejmcr.9-2288
Harvard Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar (2025) A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis. EJMCR, 27 (September 2025): -. doi:10.24911/ejmcr.9-2288
Chicago Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar. "A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis." 27 (2025), -. doi:10.24911/ejmcr.9-2288
MLA (The Modern Language Association) Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar. "A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis." 27.September 2025 (2025), -. Print. doi:10.24911/ejmcr.9-2288
APA (American Psychological Association) Style
Joris Godelaine, Christine Van Laer, Nancy Boeckx, Mercedeh Tajdar (2025) A case of thrombophagocytosis in a neonate: a rare observation highlighting the importance of timely platelet analysis. , 27 (September 2025), -. doi:10.24911/ejmcr.9-2288