Pseudo grey platelet syndrome--grey platelets due to degranulation in blood collected into EDTA.

We have studied a woman with a history of mild bruising and bleeding, with a normal platelet count and normal clotting factors, who had platelets that appeared grey when stained and viewed under the microscope. Unlike the grey platelet syndrome, the abnormality was only evident when blood had been collected into EDTA and not when citrate or heparin was used as anticoagulant. This 'pseudo grey platelet syndrome' was associated with platelet dense body and alpha granule secretion with no aggregation and occurred on removal of extracellular Ca2+. We discovered that a plasma factor was responsible which could be an immunoglobulin but which is clearly different from the EDTA-sensitive antibodies which cause platelet aggregation and agglutination. We were not able to demonstrate a relationship between the mild bleeding tendency and the in vitro abnormality.

'On line' data handling in a routine haematology department.

The use of a ;stand alone' mini computer, on line, data acquisition system is described utilising a microprocessor as an adjunct to the main central processor to increase data transmission rates. Visual display units (VDU) provide on line flexibility of data input. The system acquires, on line, the Coulter S generated parameters together with the associated patient identification data and other requested tests. Erythrocyte sedimentation rate, platelet count, and B12 and folate results are fed in at will via the VDUs, using rapid entry subroutines. Percentage differential white cell count results and the absolute leucocyte count are calculated by the microprocessor, on line input being facilitated by remote keyboards associated with the VDUs. Total editing of all requests and results is available on all ;current' (unfiled) reports via the VDUs, and this facility includes the entry of film appearances using plus symbols and predetermined comments available against a code number. This editing function is also used to enter all other results that can be made available on the computer-printed report form. The computer system also provides quality control data, immediate printout of Coulter S results outside given limits, cumulative filing for all routine and designated ;priority' results, and a daily alphabetical listing of all patients from whom specimens have been examined together with full blood count, ESR, and platelet results on specimens examined that day.

Evaluation of a rapid method for the determination of plasma fibrinogen.

In this study the method of Ellis and Stransky (1961) to determine plasma fibrinogen is evaluated, and modifications are described which have been introduced to improve the sensitivity and reduce the time taken for the test.

The Zollinger-Ellison syndrome in a child.

The Zollinger-Ellison syndrome was encountered in a boy aged 11 years who presented with a bulbar duodenal ulcer causing intractable pain and bleeding. The diagnosis was made by finding an overnight fasting gastric secretion of 1,300 ml containing 134 m-equiv/HCl, and little change of secretion after maximal histamine stimulus. A circumscribed non-beta islet cell pancreatic tumour was excised, with antrectomy. Postoperative acid secretion was normal and the boy was well after being followed up for 15 months. The diagnosis and management are discussed, as the view that total gastrectomy must be performed in all cases of the Zollinger-Ellison syndrome is questioned.