Platelet indices in the differential diagnosis of thrombocytosis

Abstract

Objective: To assess the role of platelet indices mainly: Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) for the differential diagnosis of thrombocytosis. Methods: A prospective case series study conducted at Ibn-Sena Teaching Hospital in Mosul during the period from June 2003 to January 2005. Ninety two patients with thrombocytosis were analyzed for platelets indices using Coulter MS-9. A control group of sixty normal subjects were also included in this study for comparison. Results: Thrombocytosis was found to be due to two main causes: 12 patients with myeloproliferative disorders, and 80 patients had secondary reactive causes of thrombocytosis. Patients with myeloproliferative disorders had significantly higher Mean Platelet Volume (MPV) than those with reactive thrombocytosis. Also the Platelet Distribution Width (PDW) was higher in patients with myeloproliferative disorders than those with reactive thrombocytosis and control group. Conclusion: Platelet indices especially PDW seem to be a good variable for the differential diagnosis of thrombocytosis. ‫اﻟﺨﻼﺻﺔ‬ ‫أه‬ ‫ـ‬ ‫اﻟﺒﺤﺚ‬ ‫ﺪاف‬ : ‫ﻓﻲ‬ ‫اﻟﻤﺘﻮﻓﺮة‬ ‫اﻷﺟﻬﺰة‬ ‫ﻓﻲ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫ﺑﺎﻷﻗﺮاص‬ ‫اﻟﻤﺘﻌﻠﻘﺔ‬ ‫اﻟﺒﻴﺎﻧﺎت‬ ‫أهﻤﻴﺔ‬ ‫ﻟﻤﻌﺮﻓﺔ‬ ‫اﻟﺪراﺳﺔ‬ ‫هﺬﻩ‬ ‫أﺟﺮﻳﺖ‬ ‫س‬ ‫ا‬ ‫آﻮﻟﺘﺮام‬ ‫آﺠﻬﺎز‬ ‫اﻟﻤﺴﺘﺸﻔﻴﺎت‬-٩ ‫ﻓﻲ‬ ‫اﻟﺘﻔﺮﻳﻘﻲ‬ ‫ﻟﻠﺘﺸﺨﻴﺺ‬ ‫اﻷﻗﺮاص‬ ‫ﺣﺠﻢ‬ ‫وﻣﻌﺪل‬ ‫ﻟﻸﻗﺮاص‬ ‫اﻟﺘﻮزﻳﻌﻲ‬ ‫اﻟﻄﻴﻒ‬ ‫وﺧﺎﺻﺔ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫اﻷﻗﺮاص‬ ‫زﻳﺎدة‬ ‫ﺣﺎﻻت‬. ‫اﻟﺒﺤﺚ‬ ‫ﻃﺮﻳﻘﺔ‬ : ‫درا‬ ‫اﻟﺤﺎﻻت‬ ‫ﻣﻦ‬ ‫ﻟﻤﺠﻤﻮﻋﺔ‬ ‫ﻣﺴﺘﻘﺒﻠﻴﺔ‬ ‫ﺳﺔ‬. ‫ﻣﻦ‬ ‫اﻟﻤﻮﺻﻞ‬ ‫ﻓﻲ‬ ‫اﻟﺘﻌﻠﻴﻤﻲ‬ ‫ﺳﻴﻨﺎ‬ ‫اﺑﻦ‬ ‫ﻣﺴﺘﺸﻔﻰ‬ ‫ﻓﻲ‬ ‫اﻟﺪراﺳﺔ‬ ‫ﺗﻤﺖ‬ ‫ﺣﺰﻳﺮان‬ ٢٠٠٣ ‫اﻟﺜﺎﻧﻲ‬ ‫آﺎﻧﻮن‬ ‫ﻟﻐﺎﻳﺔ‬ ٢٠٠٥. ‫اﻷﻗﺮاص‬ ‫ﺗﻜﻮن‬ ‫ﺑﺰﻳﺎدة‬ ‫ﻣﺼﺎﺑﻮن‬ ‫ﻣﺮﻳﻀﺎ‬ ‫وﺗﺴﻌﻴﻦ‬ ‫اﺛﻨﻴﻦ‬ ‫ﻋﻠﻰ‬ ‫اﻟﺪراﺳﺔ‬ ‫أﺟﺮﻳﺖ‬ ‫ﻣ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫آﻮﻟﺘﺮ‬ ‫اﻻﻟﻜﺘﺮوﻧﻲ‬ ‫اﻟﺠﻬﺎز‬ ‫ﺧﻼل‬ ‫ﻦ‬) ‫ام‬-‫اس‬-٩ (‫ا‬ ‫اﻟﺒﻴﺎﻧﺎت‬ ‫واﺳﺘﺤﺼﻠﺖ‬ ‫اﻟﺪراﺳﺔ‬ ‫وﺷﻤﻠﺖ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫ﺑﺎﻷﻗﺮاص‬ ‫ﻟﻤﺘﻌﻠﻘﺔ‬ ‫ﻟﻠﻤﻘﺎرﻧﺔ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫اﻷﻗﺮاص‬ ‫ﻣﻦ‬ ‫ﻃﺒﻴﻌﻲ‬ ‫ﻋﺪد‬ ‫ﻟﺪﻳﻪ‬ ‫ﻃﺒﻴﻌﻲ‬ ‫ﺷﺨﺼﺎ‬ ‫ﺳﺘﻮن‬. ‫اﻟﻨﺘﺎﺋ‬ ‫ــــ‬ ‫ﺞ‬ : ‫ﺑﺰﻳﺎدة‬ ‫اﻟﻤﺼﺎﺑﻮن‬ ‫اﻟﻤﺮﺿﻰ‬ ‫أن‬ ‫وﺟﺪ‬) ‫ﻓﺮط‬ (‫ﻣﺠﻤﻮﻋﺔ‬ ،‫رﺋﻴﺴﻴﺘﻴﻦ‬ ‫ﻣﺠﻤﻮﻋﺘﻴﻦ‬ ‫إﻟﻰ‬ ‫ﻳﻨﻘﺴﻤﻮن‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫اﻷﻗﺮاص‬ ‫اﻋﺘ‬ ‫ﻋﻦ‬ ‫ﻧﺎﺟﻢ‬ ‫أوﻟﻲ‬ ‫اﻋﺘﻼل‬ ‫ﻟﺪﻳﻬﻢ‬ ‫ﻣﺮﻳﻀﺎ‬ ‫ﻋﺸﺮ‬ ‫اﺛﻨﻰ‬ ‫ﻣﻦ‬ ‫ﻣﻜﻮﻧﺔ‬ ‫ﻟﺪﻳﻬﻢ‬ ‫ﻣﺮﻳﻀﺎ‬ ‫ﺛﻤﺎﻧﻴﻦ‬ ‫ﻣﻦ‬ ‫ﺗﺘﻜﻮن‬ ‫أﺧﺮى‬ ‫وﻣﺠﻮﻋﺔ‬ ‫ﻧﺨﺎﻋﻲ‬ ‫ﻼل‬ ‫ﺛﺎﻧﻮﻳﺔ‬ ‫أﺳﺒﺎب‬) ‫اﻧﻔﻌﺎﻟﻴﺔ‬ (‫اﻷﻗﺮاص‬ ‫ﻟﺰﻳﺎدة‬. ‫اﻋﺘﻼل‬ ‫ﻟﺪﻳﻬﻢ‬ ‫اﻟﺬﻳﻦ‬ ‫اﻟﻤﺮﺿﻰ‬ ‫إن‬ ‫أوﻟﻲ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫ﻟﻸﻗﺮاص‬ ‫اﻟﺘﻮزﻳﻌﻲ‬ ‫اﻟﻄﻴﻒ‬ ‫ﻓﺎن‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫اﻷﻗﺮاص‬ ‫ﻟﺰﻳﺎدة‬ ‫آﺴﺒﺐ‬ ‫ﻧﺨﺎﻋﻲ‬ ‫زﻳﺎدة‬ ‫ذوي‬ ‫أﻗﺮاﻧﻬﻢ‬ ‫ﻣﻦ‬ ‫اآﺒﺮ‬ ‫اﻷﻗﺮاص‬ ‫هﺬﻩ‬ ‫ﺣﺠﻢ‬ ‫ﻣﻌﺪل‬ ‫وآﺬﻟﻚ‬) ‫ﻓﺮط‬ (‫اﻷﺻﺤﺎء‬ ‫أﻗﺮاﻧﻬﻢ‬ ‫أو‬ ‫اﻟﺜﺎﻧﻮﻳﺔ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫اﻷﻗﺮاص‬. ‫اﻻﺳﺘﻨﺘﺎج‬ : ‫ﺟﻴﺪا‬ ‫وﻣﺘﻐﻴﺮا‬ ‫ﻣﺆﺷﺮا‬ ‫ﻳﻌﺘﺒﺮ‬ ‫ﻟﻸﻗﺮاص‬ ‫اﻟﺘﻮزﻳﻌﻲ‬ ‫اﻟﻄﻴﻒ‬ ‫وﺧﺎﺻﺔ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫ﺑﺎﻷﻗﺮاص‬ ‫اﻟﻤﺘﻌﻠﻘﺔ‬ ‫اﻟﺒﻴﺎﻧﺎت‬ ‫إن‬ ‫ﺑﻨﻮﻋﻴﻪ‬ ‫اﻟﺪﻣﻮﻳﺔ‬ ‫اﻷﻗﺮاص‬ ‫ﻓﺮط‬ ‫ﺣﺎﻻت‬ ‫ﻓﻲ‬ ‫اﻟﺘﻔﺮﻳﻘﻲ‬ ‫ﻟﻠﺘﺸﺨﻴﺺ‬ .