The Coulter STKS mean platelet volume (MPV), platelet distribution width (PDW), mean corpuscular volume (MCV), and hematocrit (HCT) are assessed in thrombotic diseases. Complete blood counts (CBCs) were studied retrospectively in 645 consecutive hospital cases and, 850 "CBCs with blood films to the pathologist." Because the MPV and PDW are time dependant, nomograms and tables were created for the 0-25-and 26-40-min elapsed time intervals. In this study, abnormal CBC platelet parameters were found in the majority of patients with common thrombotic diseases, such as diabetes, atherosclerosis, hypertension, congestive heart failure, deep vein thrombosis (DVT), and toxemia. Thrombotic disease-related CBC categories include combined elevated MPV and PDW, elevated MPV or PDW alone, "MCV/MPV mismatch" (failure of physiologic "MCV/MPV match"), rheologic problem of elevated HCT and MPV, and mild thrombocytopenia with decreased MPV and high PDW. Anticoagulants and steroids often decrease the MPV. CBC platelet parameter abnormalities provide a new useful classification of thrombotic diseases in daily practice.This article on thrombotic diseases assesses the ' clinical utility of the mean platelet volume (MPV) and platelet distribution width (PDW), rendered interpretable by creation of reference ranges for specific intervals of elapsed time, namely 025 and 26-40 min. The MPV and PDW are time dependant, and there are two recent thorough reviews that discuss the variables affecting the MPV and PDW as measured and reported by modern hematology analyzers (1,2). Many of our colleagues have stopped reporting MPV and PDW because these parameters seem to have little clinical relevance, and we agree if they are reported without benefit of the elapsed time in minutes. We quote Jackson and Carter &dquo;Platelet parameters including the MPV and the PDW have been available to the clinicians since the early 1970s, but their role in the diagnosis and management of patients remains u~clear'' fl).Our Hospital Laboratory acquired a Coulter STKS Hematology Analyzer in 1990, almost 4 years before acquisition of a main-frame computer. In 1990, all the critical data including collection and analysis times were reported on the same hematology &dquo;card&dquo;, which served as both the hematology request and report form. In January, 1992 we began reporting the PDW. Recently, we published preliminary reports on the usefulness of the platelet parameters in assessing thrombotic disease cases (3,4). In this article we report a retrospective prevalence study of the MPV and PDW on all thrombotic disease patients encountered in 1,495 consecutive cases, including hospital admissions and outpatients.
MATERIALS AND METHODS
ObjectivesOur ofginal objective was to study a series of clinical cases to determine which diseases were associated with MPV and PDW abnormalities. Following documentation of our initial observations (3,4), our new objective is a more detailed retrospective case review for purposes of further categorizing common CBC abnormalities seen in m...