COMPARISON OF PLATELET INDICES IN HYPOPRODUCTIVE AND HYPERDESTRUCTIVE THROMBOCYTOPENIA

  • Zulfania Zulfania Department of Physiology, Rehman Medical College, Peshawar, Pakistan
  • Hinna Hayat Department of Haematology, Rehman Medical College, Peshawar, Pakistan
  • Rashid Mahmood Department of Physiology, Rehman Medical Institute, Peshawar, Pakistan
  • Ashfaq Ahmad Bukhari Department of Physiology, Rehman Medical Institute, Peshawar, Pakistan
  • Yasir Ihtesham World Food Program, Peshawar, Pakistan
  • Umair Rasool Khyber Teaching Hospital, Peshawar, Pakistan
Keywords: Thrombocytopenia, Platelet, Platelet indices, Mean Platelet Volume, Platelet Distribution Width, Plate Large Cell Ratio

Abstract

Background: Thrombocytopenia is one of the most common haematological disorders and is also a life-threatening condition. The two types of thrombocytopenia, hypoproductive and hyperdestructive can best be distinguished by bone marrow examination; but it is an invasive, time-consuming and expensive process. The aim of this study was to determine the role of platelets indices in distinguishing between the two types which is a cost-effective and non-invasive modality of investigations. Methods: It was a cross-sectional study, conducted in the Pathology Laboratory, Rehman Medical Institute, Peshawar, conducted from 1st July 2019 to 30th June 2020. Non-probability convenience sampling technique was used. Sample size was calculated using WHO formula, and a total of 74 thrombocytopenic patients referred for bone marrow aspirate and trephine biopsy were included in the study. Clinical record, complete blood count (CBC) and bone marrow trephine biopsy were obtained and computed. Results: Mean Platelet Volume was 10.57±1.33 fl in hypoproductive group and 11.637±1.98 fl in hyperdestructive group. The difference between the groups was statistically significant (p=0.017). Platelet Distribution Width was 12.68±3.16 fl in hypoproductive group and 14.811±3.61 fl in hyperdestructive group (p=0.014). Platelet Large Cell Ratio was 30.81±9.23% in hypoproductive group and 36.993±10.25% in hyperdestructive group (p=0.010). Conclusion: Platelet indices can be used as a reliable tool for distinguishing between hypoproductive and hyperdestructive thrombocytopenia.

Pak J Physiol 2021;17(2):3–6

References

Parise LV. Introduction to a review series: megakaryocytes to platelets in health and disease. Blood 2016;127(10):1215.

Elsewefy DA, Farweez BA, Ibrahim RR. Platelet indices: consideration in thrombocytopenia. Egypt J Haematol 2014;39(3):134–8.

Bain BJ, Bates I, Laffan MA, Lewis SM. Dacie and Lewis Practical Haematology. Elsevier; 2016.

Negash M, Tsegaye A, G/Medhin A. Diagnostic predictive value of platelet indices for discriminating hypo productive versus immune thrombocytopenia purpura in patients attending a tertiary care teaching hospital in Addis Ababa, Ethiopia. BMC Hematol 2016;16(1):18.

Khaleed JK, Ahmed AA, Maysem Alwash AA. Platelet indices and their relations to platelet count in hypoproductive and hyper-destructive thrombocytopenia. Karbala J Med 2014;7(2):1952–8.

ten Berg MJ, Huisman A, van den Bemt PM, den Breeijen H, Egberts TC, van Solinge WW. Discriminative value of platelet size indices for the identification of the mechanism of chemotherapy-induced thrombocytopenia. Biomarkers 2011;16(1):51–7.

Yu J, Wang L, Peng Y, Xiong M, Cai X, Luo J, et al. Dynamic monitoring of erythrocyte distribution width (RDW) and platelet distribution width (PDW) in treatment of acute myocardial infarction. Med Sci Monit 2017;23:5899–906.

Kamal MY, El Gendy W, Salama A. Platelet indices as a diagnostic tool in pediatric immune thrombocytopenic purpura. Alex J Pediatr 2018;31:128–31.

Ali N, Anwar M, Ayyub M, Nadeem A, Jamal M. Thrombocytopenia: analysis of 415 patients. Pak J Pathol 2004;15:143–6.

Khairkar PS, More S, Pandey A, Pandey M. Role of mean platelet volume (MPV) in diagnosing categories of thrombocytopenia. Indan J Pathol Oncol 2016;3(4):606–10.

Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol 2005;128(5):698–702.

Ntaios G, Papadopoulos A, Chatzinikolaou A, Saouli Z, Karalazou P, Kaiafa G, et al. Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura. Acta Haematol 2008;119(3):173–7.

Shah AR, Chaudhari SN, Shah MH. Role of platelet parameters in diagnosing various clinical conditions. Natl J Med Res 2013;3(2):162–5.

Islam S, Islam MS, Ahmed MU, Aziz MA, Begum M. Role of mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) value in the diagnosis of immune thrombocytopenic purpura. Hematol Transfus Int J 2016;2(2):25–8.

Chaitra, Vaddatti T, Inuganti RV, Burela M. Role of platelet indices as a predictive tool in hypoproliferative and hyperdestructive type of thrombocytopenia. J Clin Diagn Res 2020;14(3):14–7.

Vidyadhar S. Diagnostic implication and utility of platelet indices in differentiating hypoproductive and hyperdestructive thrombocytopenia. J Dent Med Sci 2019;18(8):7–11.

Kambi DP, Roohi S. Role of platelet parameters in thrombocytopenia. Int J Clin Diagn Pathol 2019;2(2):103–6.

Pogorzelska K, Krętowska A, Krawczuk-Rybak M, Sawicka-Żukowska M. Characteristics of platelet indices and their prognostic significance in selected medical condition —a systematic review. Adv Med Sci 2020;65(2):310–5.

Khanna R, Deepak NM, Manohar C, Dhar M. A retrospective evaluation of mean platelet volume as a discriminating factor in thrombocytopenia of hypoproductive and hyperdestructive aetiologies. J Evol Med Dent Sci 2013;2(47):9059–66.

Xu RL, Zheng ZJ, Ma YJ, Hu YP, Zhuang SH. Platelet volume indices have low diagnostic efficiency for predicting bone marrow failure in thrombocytopenic patients. Exp Ther Med 2013;5(1):209–14.

Vinholt PJ, Hvas AM, Nybo M. An overview of platelet indices and methods for evaluating platelet function in thrombocytopenic patients. Eur J Haematol 2014;92(5):367–76.

Borkataky S, Jain R, Gupta R, Singh S, Krishan G, Gupta K, et al. Role of platelet volume indices in the differential diagnosis of thrombocytopenia: a simple and inexpensive method. Hematology 2009;14(3):182–6.

Babu E, Basu D. Platelet large cell ratio in the differential diagnosis of abnormal platelet counts. Indian J Pathol Microbiol 2004;47(2):202–5.

Mowafy NM, Elkeiy MT, Khedr MAH, Masselihy MHG. Role of platelet indices and antiplatelet antibody in differentiating immune thrombocytopenic purpura from other causes of thrombocytopenia. Egypt J Hosp Med 2019;74(8):1732–6.

Downloads

Download data is not yet available.
Published
2021-06-30
How to Cite
1.
Zulfania Z, Hayat H, Mahmood R, Bukhari A, Ihtesham Y, Rasool U. COMPARISON OF PLATELET INDICES IN HYPOPRODUCTIVE AND HYPERDESTRUCTIVE THROMBOCYTOPENIA. PJP [Internet]. 30Jun.2021 [cited 27Sep.2021];17(2):3-. Available from: http://pjp.pps.org.pk/index.php/PJP/article/view/1283