Evaluation of the diagnostic performance of platelet-derived indices for the differential diagnosis of thrombocytopenia in pediatrics

Aponte, Nelson; Ballesteros, Adriana Linares; Sarmiento-Urbina, Isabel Cristina; Uribe-Botero, Gloria Inés

doi:10.15446/revfacmed.v62n4.43754

Cited by 7 publications

(12 citation statements)

References 16 publications

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“…[ Table 5] Borkataky et al also noticed high mean PDW values except for non-megaloblastic subgroup of impaired production. [18] Similar results were obtained by Islam S et al [19] and Aponte-Barrios NH et al [20] Though the present study included all age groups, study by Aponte-Barrios NH et al in pediatric age group found that PDW can distinguish between thrombocytopenia due to an increase in the destruction of platelet and thrombocytopenia due to a reduction in platelet production. [20] …”

Section: Discussionsupporting

confidence: 89%

Platelet Distribution Width (PDW) - A Rarely Studied Platelet Indice for Determining the Causes of Thrombocytopenia

Khairkar¹,

Pandey²,

More³

et al. 2016

AIMDR

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Background: Thrombocytopenia (TCP) is low platelets count, which is either due to defective platelet production or due to increased platelet breakdown. The platelet number alone does not give a complete picture of platelet maturity and function, therefore, the platelet indices have been the subject of intensive study in recent years, but they have not been firmly established. Mean platelet volume (MPV) and platelet distribution width (PDW) are useful parameters in evaluating disorders of platelets. This study was undertaken to evaluate the effectiveness of PDW in diagnosing causes of thrombocytopenia. Methods: 510 cases of thrombocytopenia and 500 cases of Control group with normal platelet count were included in the study. TCP was defined as platelet counts below 1.5 lacs/cumm. Hematological analysis was done on Mindray BC-3000 plus automated hematology analyzer. All cases were reevaluated by peripheral smear examination. Only those cases were included in the study, which showed platelet count and platelet volume parameters with graph both in cases and in control group. Results: Hyper-destructive group constituted majority of the cases 352 (69%), while hypo-productive group and abnormal pooling constituted 30% and 1.42% cases respectively. The mean PDW was significantly higher in hyper-destructive group when compared with hypo-productive group, Abnormal pooling and control group. The difference was statistically significant. Conclusion: PDW provides plenty of clinical information about the causes and patho-mechanisms of thrombocytopenia and could be helpful to distinguish hyper-destructive thrombocytopenia from hypo-productive thrombocytopenia. More attention should be paid to PDW along with other platelet indices to differentiate between hyper-destructive TCP from hypo-productive and abnormal pooling TCP. .

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Section: Discussionsupporting

confidence: 89%

Platelet Distribution Width (PDW) - A Rarely Studied Platelet Indice for Determining the Causes of Thrombocytopenia

Khairkar¹,

Pandey²,

More³

et al. 2016

AIMDR

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“…O diagnóstico é confirmado por exclusão de outras causas que levam a redução no número de plaquetas, como leucemia, linfomas, doenças infecciosas, HIV, neoplasias, hepatopatias, doenças genéticas e outras patologias autoimunes, devendo ser feita a avaliação da medula (biópsia e aspirado) para confirmar ou excluir a doença. Não há exames com especificidade e sensibilidade suficiente para confirmar a PTI BRASIL, 2013;CRUZ et al, 2011;AL-MULLA et al, 2009;APONTE-BARRIOS et al, 2014;SANTANA et al, 2013). No entanto, ARAKI (2018) demonstrou que a avaliação do tamanho das plaquetas por citometria de fluxo foi útil no diagnóstico de trombocitopenia e identificaram os parâmetros associados com manifestações de sangramento na mucosa ou órgão.…”

Section: Resultsunclassified

Púrpura trombocitopênica idiopática: uma doença subdiagnosticada

Alves

Silva

et al. 2021

Sustinere

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Introdução: A púrpura trombocitopênica idiopática (PTI) é caracterizada pela destruição de plaquetas e inibição da sua produção, que se evidencia por trombocitopenia isolada. Trata-se de uma doença autoimune subdiagnosticada, pois não existe um exame próprio para diagnostica-la e devido tal circunstância a PTI é confundida com outras doenças que causam diminuição de plaquetas. Esta revisão objetiva retratar as características da púrpura trombocitopênica idiopática, como é feito seu diagnóstico e o seu tratamento. Metodologia: Para a construção desta revisão integrativa, realizou-se uma busca eletrônica de artigos de periodicidade, na Biblioteca Virtual de Saúde (BVS), nas bases de dados do Lilacs, Medline e Scielo (Scientific Electronic Library Online). Foram utilizados artigos escritos nas línguas portuguesa, inglesa e espanhola; publicados e indexados entre os anos 2000 e 2019 nas bases de dados escolhidas, que respondiam um dos seguintes questionamentos: quais os métodos utilizados para o diagnóstico de PTI e como realizar o tratamento nas diferentes etapas da doença? Resultados: A patogênese da PTI não é completamente esclarecida, sendo relacionada a uma destruição de plaquetas e inibição da sua produção. Discussão: O tratamento pode ser realizado das seguintes formas: tratamento inicial, tratamento de segunda linha, tratamento da doença refratária e tratamento em situações de emergência. Conclusão: A PTI trata-se de uma doença autoimune subdiagnosticada, pois não existe um exame próprio para diagnosticar essa patologia, devido tal circunstância a PTI é confundida com outras doenças que causam diminuição de plaquetas.

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“… 14 However, study done by Aponte-Barrios in 2014 reported a high sensitivity and specificity for MPV, PDW and PLCR in diagnosis of immune thrombocytopenia and stresses on the use of these indices as screening tool. 9 Al-Sharifi proposed a cut off value of 9.9 fL for MPV with sensitivity and specificity of 100%. 15 Our study differ from above mentioned studies in that the platelet indices had poor sensitivity and specificity for diagnosing immune thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic importance of a screening test is measured by determining area under the reactive operative characteristic (ROC) curve. 9 A good test has a larger are under the curve (AUC) and vice versa A weak test has AUC of about .5 to .6 .A good test has the AUC of about .75 to .9. An excellent test has AUC of .97 to 1.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic importance of mean platelet volume, platelet distribution width and platelet large cell ratio as screening tool in immune thrombocytopenia

Khan

Ullah

2020

Porto Biomedical Journal

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Objective: To determine diagnostic importance of mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (PLCR) in diagnosing cases of immune thrombocytopenia. Methodology: The study was done in Khyber Teaching hospital from January 2017 to May 2018. Cases with low platelet count of all the ages and both the genders were included in the study by non probability purposive sampling technique and were subjected to bone marrow aspiration to rule out other causes of thrombocytopenia and thus confirm the diagnosis of immune thrombocytopenia. The platelet indices were noted and their sensitivity, specificity and accuracy were determined for immune thrombocytopenia. Mean and standard deviation were used for quantitative data. Percentage and frequency were used to measure qualitative data. Data was analysed by SPSS. Results: 84 cases with thrombocytopenia of mean age 23.4 ± 12.1 years (range 7–81 years) were included in the study. There were 38 (45.2%) males and 46 (54.8%) females. There were 40 cases of immune thrombocytopenia. The sensitivity and specificity for PDW (59.1% and 43.1%, respectively), MPV (59.1% and 52.9%, respectively), and PLCR (50% and 52.9%, respectively) were found low to be used as screening tool for immune thrombocytopenia. Conclusion: The MPV, PDW and PLCR has low sensitivity and specificity and therefore should not be used as reliable screening tool in giving preliminary diagnosis of the immune thrombocytopenia.

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Evaluation of the diagnostic performance of platelet-derived indices for the differential diagnosis of thrombocytopenia in pediatrics

Cited by 7 publications

References 16 publications

Platelet Distribution Width (PDW) - A Rarely Studied Platelet Indice for Determining the Causes of Thrombocytopenia

Platelet Distribution Width (PDW) - A Rarely Studied Platelet Indice for Determining the Causes of Thrombocytopenia

Púrpura trombocitopênica idiopática: uma doença subdiagnosticada

Diagnostic importance of mean platelet volume, platelet distribution width and platelet large cell ratio as screening tool in immune thrombocytopenia

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