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 Table of Contents  
IMAGE IN HEMATOLOGY
Year : 2022  |  Volume : 13  |  Issue : 2  |  Page : 107-108

Platelet morphology masquerading as trypanosomiasis


Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India

Date of Submission07-Nov-2020
Date of Acceptance12-Dec-2020
Date of Web Publication04-Aug-2022

Correspondence Address:
Dr. Aparna Ningombam
Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joah.joah_212_20

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How to cite this article:
Sarkar A, Acharya S, Ningombam A, Kumar K. Platelet morphology masquerading as trypanosomiasis. J Appl Hematol 2022;13:107-8

How to cite this URL:
Sarkar A, Acharya S, Ningombam A, Kumar K. Platelet morphology masquerading as trypanosomiasis. J Appl Hematol [serial online] 2022 [cited 2022 Nov 27];13:107-8. Available from: https://www.jahjournal.org/text.asp?2022/13/2/107/353277

A 5-year-old girl presented with intermittent low-grade fever for 6 days. Blood in K2-EDTA vial was sent for hematology work-up. Giemsa-stained smear showed structures morphologically resembling trypomastigotes of Trypanosoma sp. [Figure 1] and [Figure 2]. Three independent examiners inspected the smear as trypanosomiasis is rare in the region. Although they resembled trypomastigotes, nucleus, kinetoplast, and undulating membrane were not distinguished. A fresh sample was obtained which, interestingly, showed higher platelet count with no evidence of Trypanosoma-like structure in the smear. The elements suspected to be trypomastigotes of Trypanosoma sp. were confirmed as elongated platelets by the examiners in the absence of any evidence of parasitic infection.
Figure 1: Peripheral blood smear showing various unusual platelet morphologies, some mimicking trypomastigotes (×1000)

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Figure 2: Aberrant platelet morphology mimicking trypomastigotes (×1000)

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Perroncito's and Demel's original hand-drawn illustrations depicting proplatelet have guided in understanding the origins of platelet.[1],[2] Various work on animal models regarding the formation of proplatelet and platelet are available, yet the phenomenon of proplatelet and platelet activation in vivo has not been captured by light microscopy.[3]

The appearance of these platelet morphologies in peripheral blood smear may masquerade and create plausible confusion with trypomastigotes of Trypanosoma sp. In case of suspicion, smear should be repeated. To the best of our knowledge, platelet morphology resembling trypanosomiasis has never been reported till date.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Perroncito A. Sulla derivazione delle piastrine. Haematologica 1921;2:510-26.  Back to cited text no. 1
    
2.
Cesaris Demel A. Fatti ed ipotesi sulla origine delle piastrine. Haematologica 1924;5:104-46.  Back to cited text no. 2
    
3.
Italiano JE Jr., Lecine P, Shivdasani RA, Hartwig JH. Blood platelets are assembled principally at the ends of proplatelet processes produced by differentiated megakaryocytes. J Cell Biol 1999;147:1299-312.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2]



 

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