Role of platelet volume indices in the differential diagnosis of thrombocytopenia: a simple and inexpensive method

Abstract

Thrombocytopenia may result from hypoproliferation in marrow, or peripheral destruction of platelets. Distinction between these two categories is usually made by bone marrow examination. Some studies in literature hint that platelet volume indices are differentially altered in various causes of thrombocytopenia. The present study was aimed at investigating the role of platelet volume indices in the differential diagnosis of thrombocytopenia. Sixty healthy controls and 60 patients (study group) with thrombocytopenia (platelet count < 150 x 10(9)/l) were included in the study. The study group was divided into two categories: hypoproliferative (megaloblastic and non-megaloblastic) and destructive thrombocytopenia. Clinical features, platelet counts and platelet indices were studied in both these categories, and statistical analysis was performed. Platelet counts in the three categories of thrombocytopenia were statistically not different. All the three platelet volume indices were significantly higher in megaloblastic group as compared to the non-megaloblastic hypoproliferative category. Platelet distribution width (PDW) was significantly different between destructive thrombocytopenia and non-megaloblastic hypoproliferative groups. In conclusion, we recommend the division of hypoproliferative category of thrombocytopenia into megaloblastic and non-megaloblastic types. Alterations in platelet indices, especially PDW can differentiate non-megaloblastic hypoproliferative category from both the destructive and megaloblastic thrombocytopenia category. These simple indices can be routinely used in the initial evaluation of a patient with thrombocytopenia.

Low Serum Vitamin D Levels in Egyptian Adults With Chronic Primary Immune Thrombocytopenia: A Single Center Study.

“…In disagreement with this result, a study conducted by Borkataky et al [17] who found no significant difference in the MPV between the destructive thrombocytopenia groups and the control group. However, larger platelets have more granules, aggregate more rapidly with collagen, have a higher thromboxane A2 level, and express more glycoprotein Ib and IIb/IIIa receptors than smaller platelets, which may explain the lower bleeding tendency in ITP patients [18].…”

Role of platelet indices in differentiating hypoproductive and hyperdestructive thrombocytopenia

“…But Shah et al [20] and Borkataky et al [6] found a higher PDW in hyperdestructive thrombocytopenia when compared to hypoproductive thrombocytopenia. Kaito et al [13] suggested that a PDW value of more than 17 fl and Ntaios et al [14] suggested a value between 15 and 17 fldiscrimate this two subgroups.…”

“…[4] Measurement of platelet indices in automated analysers has many advantages over manual estimation, as it is very simple, quick and inexpensive test which also eliminates the observer bias. [5,6] Further in manual method, a delay between collection of blood and smear preparation, may change the platelet morphology and also artefactual increase in platelet diameter can occur because of increased adhesiveness with flattening of the platelets on the smears. [7] Numbenjapon et al [8] found that MPV was significantly higher in hyperdestruction group compared to hypoproductive thrombocytopenia.…”

A Retrospective Evaluation of Mean Platelet Volume as a Discriminating Factor in Thrombocytopenia of Hypoproductive and Hyperdestructive Aetiologies

“…13 Other researchers such as Niethammer et al have upheld the diagnostic value of platelet histogram maximum rather than MPV to differentiate between idiopathic thrombocytopenic purpura and hypoproductive thrombocytopenia. 14 Ntaios et al have found a combination of MPV and PDW superior to platelet-large cell ratio (P-LCR).…”