A Study of Variation in Adult Thrombocytopenic Histograms
A Graph Often Overlooked
Keywords:
Histograms, thrombocytopenia, Bimodal curve, Short peak
Abstract
Background: With the advent of automation in hematology, both platelet indices and their histograms are available from the blood cell counters at no extra cost or time. The variations of histograms in various mechanisms of thrombocytopenias are explored in this study. Methods: Adults with thrombocytopenia determined with (name of the analyser) were categorized into four groups based on the mechanism of thrombocytopenia and variations in platelet histograms were studied in all groups. Data was collated and analysed using Excel. Results: A total of 224 adults with thrombocytopenia were seen, most of them had hyperdestructive type (73.6%) followed by hypoproductive type (16.08%), abnormal pooling (6.3%) and EDTA induced thrombocytopenia (4.01%). The following variations in histogram were seen; Normal curve (8.03%), Curve not touching/reaching the baseline (43.75%), Broad based curve (10.71%), Bimodal curve (7.14%), Curve with short peak (25.9%) and Saw-tooth appearance of curve (4.47%) and correlated with the above mentioned mechanisms of thrombocytopenias using SPSS software version 20. Conclusion: An awareness regarding the variations in the platelet curve ensures a good correlation with its numerical parameters and also with the etiology of thrombocytopenias. With the era of automation taking over in most of the laboratories, it is imperative to have knowledge about these simple yet, often overlooked platelet histograms.References
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22. Karagoz B, Alacacioglu A, Bilgi O, Demirci H, Ozgun A, Akyol Erikci A et al. Platelet count and platelet distribution width increase in lung cancer patients. Anatolian Journal of Clinical Investigation. 2009; 3(1): 32-4.
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2. Parveen S, Vimal M. Role of Platelet Indices in Differentiating Hypoproductive and Hyperdestructive Thrombocytopenia. Annals of Pathol Lab Med. 2017; 4(3): 288-91
3. Shah AR, Chaudhari SN, Shah MH, et al. Role of platelet parameters in diagnosing various clinical conditions. Natl J Med Res 2013; 3: 162-65
4. Khairkar PS, Pandey A, More S, Pandey M. Platelet Distribution Width (PDW) - A Rarely Studied Platelet Indice for Determining the Causes of Thrombocytopenia. Ann. Int. Med. Den. Res. 2016;2(4):193-97
5. Hamzullah K, Adnan M, Fazle B, Naila T, Ameezullah. Role of mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (PLCR) in diagnosis of hyperdestructive thrombocytopenia. Professional Med J 2019; 26(8):1266-71. DOI: 10.29309/TPMJ/2019.26.08.3867
6. 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 Hematology 2016; 16:1-8.
7. Mala K.G, Bhandari B.J, Kittur S.K. Paramountcy of platelet parameters in thrombocytopenia- Our hospital experience. Indian J Pathol Oncol. 2018; 5(4): 558-62.
8. 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.
9. Bashir AB, Saeed OK, Mohammed BA, and Ageep AK. Role of platelet indices in patients with dengue infection in red sea state, Sudan. International journal of science and research. 2015; 4(1): 1573-6
10. Amar RS, Sanjay NC, Menka HS. Role of platelet parameters in diagnosing various clinical conditions. National j med Res 2013; 3(2): 162-5.
11. Khaleel KJ, Ahmed AA, Alwash A, Anwar A. Platelet indices and their relations to platelet count in hypoproductive and hyper-destructive Thrombocytopenia. Karbala J. Med. 2014; 7(2): 1952-8
12. Borkataky S, Jain R, Gupta R, Singh S, Krishnan G, Gupta K, et al. Role of platelet volume indices in the differential diagnosis of thrombocytopenia: a simple and inexpensive method. Hematology 2009; 14: 182-6.
13. Kottke-Marchant K, Corcoran G. The laboratory diagnosis of platelet disorders: an algorithmic approach. Arch Pathol Lab Med. 2002; 126(2): 133–46
14. Elsewefy DA, Farweez BA,Ibrahim RR: Platelet indices: consideration in thrombocytopenia. Egyptian J Haematol 2014, 39: 134–8
15. Reddy RS, Phansalkar MD, Ramalakshmi PVB. Mean Platelet Volume (MPV) in Thrombocytopenia. J Cont Med A Dent. 2014; 2(2): 45-50.
16. Katti TV, Mhetre SC, Annigeri C. How far are the platelet indices mirror image of mechanism of thrombocytopenia-mystery still remains? Int J Adv Med 2014; 1: 200-5.
17. 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(5): 408-14
18. Paula ES, Ronal JH. Platelets and megakaryocytes. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Glader BE, Rodgers GM. (eds) Wintrobe’s Clinical Hematology, 11th edn. Philadelphia, PA: Lippincott Williams and Wilkins, 2001; 615–42.
19. Thomas ETA, Bhagya S, Majeed A. Clinical Utility of Blood Cell Histogram Interpretation. J Clin Diagn Res. 2017; 11(9): OE01–OE04. doi:10.7860/JCDR/2017/28508.10620
20. Sahin C, Kırlı I, Sozen H, Canbek TD. EDTA-induced pseudothrombocytopenia in association with bladder cancer. BMJ Case Rep. 2014; 2014: bcr2014205130. Published 2014 Jun 20. doi:10.1136/bcr-2014-205130
21. Shabnam I, D S C, B C J. Ethylenediaminetetraacetic Acid (EDTA) - dependent pseudothrombocytopenia: a case report. J Clin Diagn Res. 2014; 8: FL03–4.
22. Karagoz B, Alacacioglu A, Bilgi O, Demirci H, Ozgun A, Akyol Erikci A et al. Platelet count and platelet distribution width increase in lung cancer patients. Anatolian Journal of Clinical Investigation. 2009; 3(1): 32-4.
23. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010; 14(1): 28–32.
Published
2020-03-12
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