Diagnostic Implication of Mean Platelet Volume in Thrombocytopenia
Keywords:
mean platelet volume, thrombocytopenia, Platelet count
Abstract
Introduction: The newer haematology analysers measure the platelet indices such as the mean platelet volume (MPV), platelet large cell ratio and platelet distribution width. It has been observed that MPV is increased in conditions associated with thrombocytopenia due to peripheral destruction. This study was carried out to know the utility of MPV and derive cut-off values in categorizing the conditions causing thrombocytopenia into hyperdestructive and hypoproliferative groups. Methods: The thrombocytopenia cases were categorized into two groups as hyperdestructive and hypoproliferative groups based on the bone marrow findings. The MPV on the day of admission was taken into consideration. The data were analysed using the mean, standard deviation and the t-test. ROC curve was plotted to derive the cut-off MPV value. Results: Of the total 89 thrombocytopenia cases, 53 were of hyperdestructive etiology and 36 were of hypoproliferative etiology. The mean MPV for group A was 9.56 with a standard deviation of 1.34 and that for group B was 8.45 with a standard deviation of 1.30. The p value was < 0.001. From the ROC curve, a cut off of 8.5 fl was taken. Conclusion: We conclude that a MPV value of >8.5fl is suggestive of a hyperdestructive etiology. Even though bone marrow remains a gold standard to distinguish between the hyperdestructive and hypoproductive thrombocytopenia groups, platelet indices like MPV can be used to aid in the diagnosis of etiology of thrombocytopenia.References
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17. Rajantie J, Javela K, Joutsi K L, Kekomäki R. Chronic thrombocytopenia of childhood: Use of non‑invasive methods in clinical evaluation. Eur J Haematol 2004;72:268‑72.
18. Niethammer AG, Forman EN. Use of the platelet histogram maximum in evaluating thrombocytopenia. Am J Hematol 1999;60:19-23.
19. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med 2012; 44:805–816.
2. Giles C. The platelet count and mean platelet volume. Br J Haematol 1981;48:31-7.
3. Demirin H, Ozhan H, Ucgun T, Celer A, Bulur S, Cil H, Gunes C, Yildirim HA. Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study. Thromb Res. 2011 Oct;128(4):358-60.
4. 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;30:408-14.
5. Negash M, Tsegaye A, Medhin AG. Diagnostic predictive value of platelet indices for discriminating hypo productive versus immune thrombocytopenia purpura in patients attending a tertiary care teaching hospital in Addis Ababa, Ethiopia. BMC Hematol. 2016;16(1):18.
6. Elsewefy D, Farweez B, Ibrahim R,. Platelet indices: consideration in thrombocytopenia. Egypt J Haematol . 2014;39(3):134.
7. Gulati I, Kumar H, Sheth J, Dey I. Diagnostic implication of mean platelet volume in thrombocytopenia. Med J DY Patil Univ 2017;10:370-5.
8. Parveen S, Vimal M. Role of Platelet Indices in Differentiating Hypoproductive and Hyperdestructive Thrombocytopenia. Annals of Pathology and Laboratory Medicine, 2017; 4(3) :4–7.
9. Van der Lelie J, Von dem Borne AK. Increased mean platelet volume in septicaemia. J Clin Pathol 1983;36:693‑6.
10. Reddy RS, Phansalkar MD, Ramalakshmi PV. Mean platelet volume (MPV) in thrombocytopenia. J Contemp Med Dent 2014;2:45‑50.
11. Khanna R, Nayak DM, Manohar C, Dhar M. A retrospective evaluation of mean platelet volume as a discriminating factor in thrombocytopenia of hypoproductive and hyperdestructive aetiologies. J Evol Med Dent Sci 2013;2:9059‑65.
12. Nehara HR, Meena SL, Parmar S, Gupta BK. Evaluation of platelet indices in patients with dengue infections. Int J Sci Res 2016;5:78‑81.
13. Shah A, Chaudhari SN, Shah MH. Role of platelet parameters in diagnosing various clinical conditions. Natl J Med Res 2013;3:162‑5.
14. Ranjith MP, Divya R, Mehta VK, Krishnan MG, KamalRaj R, Kavishwar A. Significance of platelet volume indices and platelet count in ischaemic heart disease. J Clin Pathol 2009;62:830‑3.
15. Confino-Cohen R, Chodick G, Shalev V, Leshno M, Kimhi O, Goldberg A. Chronic urticaria and autoimmunity: associations found in a large population study. J Allergy Clin Immunol (2012) 129(5):1307–13.
16. 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;119:173‑7.
17. Rajantie J, Javela K, Joutsi K L, Kekomäki R. Chronic thrombocytopenia of childhood: Use of non‑invasive methods in clinical evaluation. Eur J Haematol 2004;72:268‑72.
18. Niethammer AG, Forman EN. Use of the platelet histogram maximum in evaluating thrombocytopenia. Am J Hematol 1999;60:19-23.
19. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med 2012; 44:805–816.
Published
2020-03-11
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