Clinical haematology · UKMLA & AKT
Platelet abnormalities on blood film
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise platelet abnormalities on blood film — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Howell-Jolly bodies and siderocytes - nuclear remnants and iron-containing granules normally removed by spleen; presence = hyposplenism
- Causes of hyposplenism: coeliac disease (commonest medical cause in UK), post-splenectomy, sickle cell disease (autosplenectomy), splenic irradiation
- Platelet clumping - grape-like clusters at film periphery/feathered edge; causes spuriously low platelet count (pseudo-thrombocytopenia)
- Giant platelets - approaching/exceeding red cell size; seen in ITP, Bernard-Soulier syndrome, myeloproliferative disorders
- Thrombocytopenia + schistocytes - jagged helmet-shaped red cell fragments + low platelets = MAHA until proven otherwise (TTP, HUS, DIC, HELLP)
- Hypogranular platelets - pale, poorly granulated; suggests myelodysplastic syndrome or grey platelet syndrome
Howell-Jolly bodies + siderocytes on blood film = hyposplenism. In the context of coeliac disease, malabsorption causes hyposplenism - a classic exam pairing.
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