Study of Platelet Indices and Their Interpretation in Thrombocytopenia in a Tertiary Care Hospital

Abstract

BACKGROUND Thrombocytopenia may either be due to increased destruction or impaired production of platelets. Platelet count alone is not enough to determine the mechanism of low platelets. Platelet indices like mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR) and platelet crit (PCT) can help determine the cause and we aimed at finding their role and function in cases of thrombocytopenia. METHODS An observational cross-sectional study of 155 patients with thrombocytopenia and 71 controls was done for a period of six months in SGT Hospital, Gurugram, to determine the mechanism behind the low platelet count with the help of these indices. RESULTS The mean values of the platelet indices (PDW, P-LCR and PCT) were found to be higher in accelerated destruction group (P < 0.05) in comparison to hypoproductive group, whereas, mean MPV values were higher in the former, but was not statistically significant. On comparison with the controls, both the groups of thrombocytopenia showed a statistically significant difference with P < 0.005 in all the four indices. Mean PCT values showed a highly significant difference between the two groups as well as with controls (P < 0.001) and also the relationship of PCT with severity of thrombocytopenia showed a direct relationship which was also significant (P < 0.001). CONCLUSIONS In distinguishing between the cause of thrombocytopenia i.e., hypoproductive or hyper destruction, platelet parameters play an important role. These platelet indices are easily available with the help of automated haematology analysers and can reduce the need for costly and invasive tests for evaluation of thrombocytopenia. KEY WORDS Mean Platelet Volume, Platelet crit, Platelet Distribution Width, Platelet Large Cell Ratio, Thrombocytopenia

Role of platelet volume indices in diagnostic approach of thrombocytopenia

“…Grade 1 thrombocytopenia is most frequent (47%) followed by grade 2 (24%), grade 3 (15.0%) and grade 4 (14%). In a similar study done by Mittal V et al [10] classified thrombocytopenia into three categories: mild thrombocytopenia (platelet count 100 to 150 x 10 9 / L), moderate thrombocytopenia (platelet count > 50 x 10 9 / L and 100 x 10 9 / L), and severe thrombocytopenia (platelet count less than 50 x 10 9 / L). Mild thrombocytopenia was the most common type, followed by moderate and severe thrombocytopenia.…”

“…In this study, Male preponderance was observed similar to other studies (M:F-1.4: 1 ). Mittal V et al [10] did a study on patients aged 1 to 80 years old and found that 65 percent of the patients were male and 35 percent were female. Francis et al [11] found 61.2% male and 38.8% female patients, with a male to female ratio of 1.57:1.…”

A comparison of platelet indices in children with urinary tract and tonsillitis infection

“…sex, ethnicity etc., (2). Platelet indices include: PDW, MPV, PCT and P-LCR which are used to determine cases of thrombocytopenia (3). In children, urinary tract infection (UTI) is most common disease caused by bacterial infections which could lead to severe morbidity and mortality (4).…”