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HelpTest Code PTEM Platelet Transmission Electron Microscopic Study, Whole Blood
Method Name
Transmission Electron Microscopy
Specimen Type
Whole Blood ACDShipping Instructions
Send specimen Monday through Wednesday.
Specimens must be received in testing laboratory within 72 hours of collection. Ship specimen overnight in an Ambient Shipping Box-Critical Specimens Only (T668) following the instructions in the mailer.
Necessary Information
Platelet Esoteric Testing Patient Information is required. Testing may proceed without the patient information, however, the information aids in providing a more thorough interpretation. Ordering providers are strongly encouraged to fill out the form and send with the specimen.
Specimen Required
Patient Preparation: Fasting is preferred but not required.
Supplies: Ambient Shipping Box-Critical Specimens Only (T668)
Collection Container/Tube:
Preferred: Yellow top (ACD, solution B)
Acceptable: Yellow top (ACD, solution A)
Specimen Volume: 6 mL
Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.
Specimen Minimum Volume
3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Whole Blood ACD | Ambient | 72 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
Clinical Information
Patients with either hereditary or acquired platelet disorders usually have bleeding diathesis, which can potentially be life threatening. A reliable laboratory diagnosis of a platelet disorder can significantly impact patients' and, potentially, their family members' clinical management and outcome.
Platelet transmission electron microscopy (PTEM) has been an essential tool for laboratory diagnosis of various hereditary platelet disorders since it was first used to visualize fibrin-platelet clot formation in 1955. PTEM employs 2 main methods to visualize platelet ultrastructure, whole mount (WM) TEM and thin section (TS) TEM.
WM-TEM is considered the gold standard test for diagnosing dense granule deficiencies in Hermansky-Pudlak syndrome, alpha-delta platelet storage pool deficiency, Paris-Trousseau-Jacobsen syndrome, Wiskott-Aldrich syndrome, TAR (thrombocytopenia, absent radii) syndrome, Chediak-Higashi syndrome, and more.
TS-TEM is a preferred method to visualize platelet alpha granules, other organelles, and abnormal inclusions.
Platelet disorders that can be detected by PTEM include (but are not limited to):
Delta granules (dense bodies):
-Hermansky Pudlak syndrome
-Wiskott-Aldrich syndrome
-Chediak Higashi syndrome
-Jacobson/Paris-Trousseau syndrome
-York platelet syndrome
-Storage pool deficiency, not otherwise specified
Alpha granules:
-Gray platelet syndrome
-White platelet syndrome
-X-linked GATA-1 variant
-Jacobson/Paris-Trousseau syndrome
Alpha and delta granules:
-Alpha-delta storage pool deficiency
Reference Values
Mean dense granules/platelet: ≥1.2
Day(s) Performed
Monday through Friday
Report Available
10 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
85390
88348
Forms
1. Platelet Esoteric Testing Patient Information is required.
2. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.