[Markedly increased red cell fragmentations counted as platelets in a patient with thrombotic microangiopathy].

A patient with acute lymphocytic leukemia (ALL) experienced severe thrombotic microangiopathy (TMA) after allo-bone marrow transplantation (BMT). She had high risk for TMA; due to total body irradiation (TBI), intensive chemotherapy, treatment with Ciclosporin and association with veno-occlusive disease (VOD). Markedly increased fragmentations of red blood cells were observed in this case, and were incorrectly counted as platelets by a fully automated blood cells counter. Careful evaluation of the platelet count is necessary in patients with red cell fragmentations.