Role of platelet indices in differentiating hypoproductive and hyperdestructive thrombocytopenia
Keywords:
Thrombocytopenia, Platelet Indices, Mean Platelet Volume, Plateletcrit, Platelet Distribution Width
Abstract
Background:During evaluation of thrombocytopenic patients, it is essential to identify the etiology, whether it is due to hypoproduction or hyperdestruction which will have impact on the management. Aim of study is to evaluate the variation and relationship of platelet indices in hypoproductive and hyperdestructive thrombocytopenia patients.Methods: A cross sectional study for a period of 2 months on Patients with thrombocytopenia. Platelet count, Plateletcrit (PCT), Platelet Distribution Width (PDW) and Mean Platelet Volume (MPV) and relevant clinical details of the thrombocytopenic patients were collected and tested for statistical significance by unpaired t test.Results:This study included 120 patients of thrombocytopenia who were classified into hypoproductive (26 cases) and hyperdestructive (94 cases). The mean platelet count in hypoproduction group is 75.9 ± 36.4 and in hyperdestruction group is 79.6 ± 36.3 with a P value of 0.64. The mean MPV in hypoproduction group is 10.17 ± 1.3 and in hyperdestruction group is 12.3 ± 0.9 with a significant P value of 0.05. The mean PDW in hypoproduction group is 19.7 ± 5.4 and in hyperdestruction group is 19.3 ± 4.2 with a P value of 0.7. The mean PCT in hypoproduction group is 0.06 ± 0.03 and in hyperdestruction group is 0.08 ± 0.1 with a P value of 0.2.Conclusion: Mean platelet volume may provide useful information in discriminating the hypoproductive and hyperdestructive thrombocytopenia. Interpretation of platelet indices can help the thrombocytopenic patients in the initial management and can avoid invasive investigations. DOI: 10.21276/APALM.1357References
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6. Borkataky S, Jain R, Gupta R, Singh S, Krishan G, Gupta K, et al. Role of platelet volume indices in the differential diagnosis of thrombocytopenia: a simple and inexpensive method. Hematology. 2009 Jun;14(3):182–6.
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10. Ntaios G, Papadopoulos A, Chatzinikolaou A, Saouli Z, Karalazou P, Kaiafa G, et al. Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura. Acta Haematol. 2008;119(3):173–7.
11. Rajantie J, Javela K, Joutsi-Korhonen L, Kekomäki R. Chronic thrombocytopenia of childhood: use of non-invasive methods in clinical evaluation. Eur J Haematol. 2004 Apr 1;72(4):268–72.
12. Gardner FH, Bessman JD. Thrombocytopenia due to defective platelet production. Clin Haematol. 1983 Feb;12(1):23–38.
13. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol. 2005 Mar;128(5):698–702.
14. Ntaios G, Papadopoulos A, Chatzinikolaou A, Saouli Z, Karalazou P, Kaiafa G, et al. Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura. Acta Haematol. 2008;119(3):173–7.
15. Tomita E, Akatsuka JI, Kokubun Y. Differential diagnosis of various thrombocytopenias in childhood by analysis of platelet volume. Pediatr Res. 1980 Feb;14(2):133–7.
16. Nakadate H, Kaida M, Furukawa S, Ishii M, Higashihara M. Use of the Platelet Indices for Differential Diagnosis of Pediatric Immune Thrombocytopenic Purpura (ITP). Blood. 2008 Nov 16;112(11):4557–4557.
17. Baynes RD, Lamparelli RD, Bezwoda WR, Gear AJ, Chetty N, Atkinson P. Platelet parameters. Part II. Platelet volume-number relationships in various normal and disease states. South Afr Med J Suid-Afr Tydskr Vir Geneeskd. 1988 Jan 9;73(1):39–43.
18. Bashir AB, Saeed OK, Mohammed BA, Ageep AK. Role of Platelet Indices in Patients with Dengue Infection in Red Sea State, Sudan. [cited 2015 Dec 5]; Available from: http://www.ijsr.net/archive/v4i1/SUB15582.pdf
19. Shah AR, Chaudhari SN, Shah MH. Role of Platelet Parameters in Diagnosing Various Clinical Conditions. Hypertension. 2011;89:11–13.
20. Shah AR, Chaudhari SN, Shah MH. Role of Platelet Parameters in Diagnosing Various Clinical Conditions. Natl J Med Res. 2013;3(2):162–5.
21. Xu R-L, Zheng Z-J, Ma Y-J, Hu Y-P, Zhuang S-H. Platelet volume indices have low diagnostic efficiency for predicting bone marrow failure in thrombocytopenic patients. Exp Ther Med. 2013 Jan;5(1):209–14.
22. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med. 2012 Dec;44(8):805–16.
23. Katti T, Mhetre S, Annigeri C. How far are the platelet indices mirror image of mechanism of thrombocytopenia-mystery still remains? Int J Adv Med. 2014;1(3):200.
2. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol. 2005 Mar;128(5):698–702.
3. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002 Sep;13(5–6):301–6.
4. Giovanetti TV, do Nascimento AJ, de Paula JP. Platelet indices: laboratory and clinical applications. Rev Bras Hematol E Hemoter. 2011;33(2):164–5.
5. Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggegation responses in healthy volunteers. J Thromb Thrombolysis. 2006 Dec 5;22(3):161–4.
6. Borkataky S, Jain R, Gupta R, Singh S, Krishan G, Gupta K, et al. Role of platelet volume indices in the differential diagnosis of thrombocytopenia: a simple and inexpensive method. Hematology. 2009 Jun;14(3):182–6.
7. Nelson RB, Kehl D. Electronically Determined Platelet Indices in Thro rn bocytopen ic Pa tien ts. Cancer. 1981;48:954–956.
8. Numbenjapon T, Mahapo N, Pornvipavee R, Sriswasdi C, Mongkonsritragoon W, Leelasiri A, et al. A prospective evaluation of normal mean platelet volume in discriminating hyperdestructive thrombocytopenia from hypoproductive thrombocytopenia. Int J Lab Hematol. 2008 Oct;30(5):408–14.
9. Kottke-Marchant K, Corcoran G. The laboratory diagnosis of platelet disorders: an algorithmic approach. Arch Pathol Lab Med. 2002;126(2):133–146.
10. Ntaios G, Papadopoulos A, Chatzinikolaou A, Saouli Z, Karalazou P, Kaiafa G, et al. Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura. Acta Haematol. 2008;119(3):173–7.
11. Rajantie J, Javela K, Joutsi-Korhonen L, Kekomäki R. Chronic thrombocytopenia of childhood: use of non-invasive methods in clinical evaluation. Eur J Haematol. 2004 Apr 1;72(4):268–72.
12. Gardner FH, Bessman JD. Thrombocytopenia due to defective platelet production. Clin Haematol. 1983 Feb;12(1):23–38.
13. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol. 2005 Mar;128(5):698–702.
14. Ntaios G, Papadopoulos A, Chatzinikolaou A, Saouli Z, Karalazou P, Kaiafa G, et al. Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura. Acta Haematol. 2008;119(3):173–7.
15. Tomita E, Akatsuka JI, Kokubun Y. Differential diagnosis of various thrombocytopenias in childhood by analysis of platelet volume. Pediatr Res. 1980 Feb;14(2):133–7.
16. Nakadate H, Kaida M, Furukawa S, Ishii M, Higashihara M. Use of the Platelet Indices for Differential Diagnosis of Pediatric Immune Thrombocytopenic Purpura (ITP). Blood. 2008 Nov 16;112(11):4557–4557.
17. Baynes RD, Lamparelli RD, Bezwoda WR, Gear AJ, Chetty N, Atkinson P. Platelet parameters. Part II. Platelet volume-number relationships in various normal and disease states. South Afr Med J Suid-Afr Tydskr Vir Geneeskd. 1988 Jan 9;73(1):39–43.
18. Bashir AB, Saeed OK, Mohammed BA, Ageep AK. Role of Platelet Indices in Patients with Dengue Infection in Red Sea State, Sudan. [cited 2015 Dec 5]; Available from: http://www.ijsr.net/archive/v4i1/SUB15582.pdf
19. Shah AR, Chaudhari SN, Shah MH. Role of Platelet Parameters in Diagnosing Various Clinical Conditions. Hypertension. 2011;89:11–13.
20. Shah AR, Chaudhari SN, Shah MH. Role of Platelet Parameters in Diagnosing Various Clinical Conditions. Natl J Med Res. 2013;3(2):162–5.
21. Xu R-L, Zheng Z-J, Ma Y-J, Hu Y-P, Zhuang S-H. Platelet volume indices have low diagnostic efficiency for predicting bone marrow failure in thrombocytopenic patients. Exp Ther Med. 2013 Jan;5(1):209–14.
22. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med. 2012 Dec;44(8):805–16.
23. Katti T, Mhetre S, Annigeri C. How far are the platelet indices mirror image of mechanism of thrombocytopenia-mystery still remains? Int J Adv Med. 2014;1(3):200.
Published
2017-06-13
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