Diagnostic implication of mean platelet volume in thrombocytopenia

Abstract

Background: A well-known cause of thrombocytopenia is peripheral platelet destruction in which the circulating platelets are premature and large. Many times a bone marrow examination is conducted to find out the etiology of thrombocytopenia. Assessment of platelet parameters like mean platelet volume (MPV) generated by a hematology analyzer is also believed to be helpful for guiding the clinicians to identify such cases. Aims: This study aims to ascertain whether raised MPV correlates with thrombocytopenia due to hyperdestruction of platelets. Materials and Methods: This was 2 years unicentric prospective observational study which included 100 thrombocytopenic patients. Their clinical diagnosis, platelet counts, and MPV values were recorded. Peripheral blood smears (PBS) were also examined for megaplatelets. Each case was put in Group A (hyperdestructive etiology) or Group B (hypoproductive etiology). Results: Group A had 79 cases out of which 53 had an MPV value more than 10.5 fl. In the rest, although MPV was not prominently raised, the PBS did show megaplatelets. Group B had 21 cases, which were not associated with a high MPV. A receiver operating characteristic curve was plotted, and Youden's index was used to find out a cutoff value for MPV (8.5 fl) which gave the maximum sensitivity and specificity to discriminate thrombocytopenia cases of hyperdestructive etiology from the rest. Conclusion: MPV is an accurate, reliable, and easily obtained platelet parameter which is helpful in diagnosing the basic etiology of thrombocytopenia. It is also a less painful alternative than the bone marrow examination for the patient.