Can Macrothrombocytopenia Mislead the Treatment of Idiopathic Thrombocytopenia Purpura?

Idiopathic thrombocytopenia purpura (itp) is an autoimmune disorder characterized by isolated thrombocytopenia and mucocutaneous bleeding. the former has a primary role in the diagnosis and treatment of itp. one of the leading causes of miscounted platelets in patients who suffer from itp is giant platelets which may indicate factitiously a severe false thrombocytopenia. here, a case of macrothrombocytopenia is presented in an itp patient. giant platelets of this patient not only resulted in miscounting platelets but also falsely increased reading of rbc counts. by counting platelets through peripheral blood smear and hemocytometer, the patient was saved from an unnecessary splenectomy.