Role of Platelet Indices as a Predictive Tool in Hypoproliferative and Hyperdestructive Type of Thrombocytopenia EC14-EC17
Dr. Tejeswini Vaddatti,
Department of Pathology, NRI Medical College, Chinakakani, Guntur-522503, Andhra Pradesh, India.
Introduction: Platelet count below 150Ã—109/L defines thrombocytopenia, which can be due to hypoproliferation or peripheral hyperdestruction, distinction of which is made by bone marrow examination. Advances in automated blood cell analysers have made it possible to measure various platelet indices like Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), and Plateletcrit (PCT) which may be helpful in evaluating thrombocytopenia cases.
Aim: To investigate the role of platelet indices in discriminating hypoproliferative and hyperdestructive type of thrombocytopenia. Materials and Methods: This was a cross-sectional study of 300 thrombocytopenia cases investigated with bone marrow examination over a period of four years from September 2015 to August 2019. Cases were divided into hypoproliferative and hyperdestructive types, Platelet indices (MPV, PCT, PDW) and platelet count were evaluated for any significant correlation between both types of thrombocytopenia and normal controls using studentâ€™s t-test.
Results: Out of 300 cases of thrombocytopenia, 200 cases were hypoproliferative type and 100 cases were hyperdestructive type with their mean age of 40.03 years and 38.58 years; and male to female ratio of 1.59:1 and 1:2.57, respectively. Statistically significant correlation (p=0.05) was noted when means of platelet count, MPV, PDW and PCT of hypoproliferative and hyperdestructive group was compared with control group individually. When platelet parameters of hypoproliferative groups were compared with hyperdestructive group, only platelet count and MPV showed significant (p=0.05) correlation. Among the three platelet indices, only MPV showed significant correlation (p=0.02) among the study groups for which Receiver Operating Characteristic (ROC) curve analysis was performed with AUC (area under the ROC curve) of 0.591, sensitivity 57% and specificity 55% at MPV cut-off of 8.8 fl.
Conclusion: MPV can be useful as a screening test for differentiating hypoproliferative type of thrombocytopenia from hyperdestructive type and may help in avoiding or delaying irrelevant invasive procedure such as bone marrow aspiration or preventing useless transfusion of platelets among hyperdestructive thrombocytopenia patients.