KLINISCHE CHEMIE KCHL Pubmed artikelen Sunitinib-associated pseudothrombocytopenia induced by IgM antibody. Albersen A, Porcelijn L, Schilders J, Zuetenhorst H, Njo TL, Hamberg P. Platelets. 2012 Oct 15. PMID: 23066976. BACKGROUND: Thrombocytopenia is a well-documented adverse reaction of sunitinib. Thrombocytopenia was observed in a patient with metastatic renal clear-cell carcinoma undergoing sunitinib treatment. Platelet count in an ethylenediaminetetraacetic acid (EDTA) sample was 19 × 10(9)/l. To exclude pseudothrombocytopenia (PTCP), a platelet count in citrate-anticoagulated blood was performed, showing a platelet count of 6 × 10(9)/l. Due to the apparent thrombocytopenia, the patient received platelet concentrates. Subsequent analyses revealed PTCP whereby platelet clumping was most abundant in citrate - followed by EDTA- and heparin-anticoagulated blood samples. This effect was partially reversed after placing blood samples at 37°C. The IgM antiplatelet autoantibodies responsible for in vitro agglutination are temperature and multianticoagulant dependent and did not react to amikacin pre-supplementation. Remarkably, the antibody revealed specificity to platelet antigens other than GPIIb/IIIa, GPIb/IX, GPIa/IIa, GPIV, and GPV. After 16 days of discontinuing sunitinib, no PTCP and no platelet reactive antibodies could be detected. We report a case of PTCP with clear time-relation with sunitinib, strongly suggesting the mechanism to be sunitinib dependent. Since this finding has not been described before, non-recognition of PTCP during sunitinib treatment might lead to dose reduction or unwarranted therapy. Voordrachten Sunitinib Associated Thrombocytopenia: Not always what it seems. Albersen A, Porcelijn L, Schilders J, Zuetenhorst H, Njo TL, Hamberg P. Rotterdam: Wetenschapsdag Sint Franciscus Gasthuis, 13 april 2012. Tweede prijs beste voordracht. Celtellingen als 24 uurs service: Flowcytometrie from bench to bedside? Van de Geijn GJM. Rotterdam: Sint Franciscus Gasthuis, Wetenschappelijk Café, 1 Februari 2012. Differentiatie tussen bacteriële en niet-bacteriële infecties bij COPD patiënten met exacerbatie op de SEH. Van de Geijn GJM, Denker S, Koeleman JGM, Birnie E, Braunstahl GJ, Njo TL. Amersfoort: Wetenschapsdag Ned. Vereniging Klinische Chemie, 19 April 2012. Leukocyten telling in bloed mbv flowcytometrie. Van de Geijn GJM. Rotterdam: Refereeravond Klinische Chemie, Sint Franciscus Gasthuis en IJsselland Ziekenhuis, 25 Juni 2012. 50 WETENSCHAPPELIJK jaarverslag 2012 Pagina 49

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