Diagnostic importance of mean platelet volume, platelet distribution width and platelet large cell ratio as screening tool in immune thrombocytopenia

Objective: To find out the correlation between the red blood cell and platelet indices in patients presenting with iron deficiency anemia at a tertiary care hospital of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Hematology, Combined Military Hospital Lahore, from Sep 2018 to Mar 2019. Methodology: The patients of age 1-70 years of either gender presenting with IDA were included in the study. The blood sample of patients were sent to laboratory to assess the red blood cell and platelet indices. SPSS-23 was used to analyze data. Results: Two hundred and seven patients fulfilling the inclusion criteria were included in this study. The mean age was 25.6 ±17.8years. Correlation was weak and insignificant between haemoglobin and packed cell volume (r=-0.385**, p<0.01), haemoglobin and mean cell volume (r=-0.225**, p<0.01), packed cell volume and mean cell haemoglobin (r =0.263**, p<0.01), & mean cell haemoglobin and mean platelet volume (r=0.143*, p<0.05). Correlation was moderate and significant between platelet distribution width and mean platelet volume (r=0.511**) & platelet distribution width and platelet large cell ratio (0.502**, p<0.01). Correlation was strong between mean platelet volume and platelet large cell ratio (r=0.759**, p<0.01). Conclusion: In conclusion, there was significant relation between red blood cell and platelets indices in iron deficiency anemia. Furthermore, haemoglobin and packed cell volume are weekly correlated, platelet distribution width and mean platelet volume are moderately correlated and mean platelet volume and platelet large cell ratio are strongly correlated.

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

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/96 ◽

2021 ◽

Vol 10 (7) ◽

pp. 435-439

Author(s):

Vani Mittal ◽

Munesh Munesh ◽

Irbinder Kour Bali ◽

Sunil Arora ◽

Jyoti Singh ◽

...

Keyword(s):

Platelet Count ◽

Mean Platelet Volume ◽

Large Cell ◽

Care Hospital ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Cell Ratio ◽

Platelet Indices ◽

Significant Difference

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

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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

Hematology & Transfusion International Journal ◽

10.15406/htij.2016.02.00031 ◽

2016 ◽

Vol 2 (2) ◽

Author(s):

Mesbah Uddin Ahmed

Keyword(s):

Immune Thrombocytopenic Purpura ◽

Mean Platelet Volume ◽

Large Cell ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Thrombocytopenic Purpura ◽

Distribution Width ◽

Cell Ratio

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Platelets volume indexes and cardiovascular risk factors

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.64.06.554 ◽

2018 ◽

Vol 64 (6) ◽

pp. 554-559 ◽

Cited By ~ 7

Author(s):

Thaís Resende Batista ◽

Roberta Carvalho de Figueiredo ◽

Danyelle Romana Alves Rios

Keyword(s):

Risk Factors ◽

Large Cell ◽

Review Literature ◽

Preventive Strategies ◽

Platelet Distribution Width ◽

Epidemiological Evidence ◽

Platelet Volume ◽

Distribution Width ◽

Cell Ratio ◽

Subclinical Marker

SUMMARY Obesity, diabetes and hypertension are risk factors for cardiovascular diseases (CVD) because they promote a state of hypercoagulability. It is known that platelets play an important role in the development of atherosclerosis. Recent studies have evaluated platelet volume indexes (PVIs) in individuals with risk factors for CVD to better understand the platelet mechanisms involved in their development. The IVPs indirectly estimate platelet function and are easily obtained from automated hematology analyzers, which provide platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and the platelet-large cell ratio (P-LCR). The present study aims to review literature studies that investigated the association between PVIs and obesity, diabetes, and arterial hypertension, in order to evaluate its use as a potential subclinical marker of CVD. Studies have shown promising results for MPV, an index that allows for early detection of platelet activation and may be useful in identifying patients before the onset of CVD development so that preventive strategies can be implemented. The PDW, although evaluated by a smaller number of studies, also showed promising results. However, there is still a long way to go in order for the MPV and PDW to be used in clinical practice, since there is still a need for more epidemiological evidence, establishing reference values, and standardizing the way results are presented.

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Role of mean platelet volume (MPV), platlet distribution width (PDW) and platelet large cell ratio (PLCR) in diagnosis of hyperdestructive thrombocytopenia.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.08.3867 ◽

2019 ◽

Vol 26 (08) ◽

pp. 1266-1271

Author(s):

Hamzullah Khan ◽

Adnan Masood ◽

Fazle Bari ◽

Naila Tabassum ◽

Ameezullah

Keyword(s):

Bone Marrow ◽

Mean Platelet Volume ◽

Megaloblastic Anemia ◽

Large Cell ◽

Prognostic Indicators ◽

Platelet Volume ◽

Distribution Width ◽

Cell Ratio ◽

Platelet Indices ◽

Study Results

Thrombocytopenia has been shown to have significant mortality if ignored. Platelet indices have been reported to be useful prognostic indicators. The objectives of this study was to determine the diagnostic importance of the platelet indices in diagnosis of hyperdestructive thrombocytopenia i.e ITP. Study Design: Cross sectional observational study. Setting: Department of Pathology (MTI) Qazi Hussain Ahmed Medical Comeplex Nowshera Medical College. Period: Aug 2017 to Jan 2018. Materials and Methods: These blood samples were analyzed in clinical Pathology laboratory of QHAMC. Required information’s were recorded on predesigned proforrma as per objectives of the study. Results: The peripheral smears of 139 cases were reported in the study. Detailed history and Thorough clinical examination was conducted. Mean age of the study population of the patients with standard deviation was 30.90(±6.4) years. Mean platelet count was 27. 37(±12.8) x109/. Mean platelet volume MPV was 11.4(±1.4) fl. Mean platelet distribution width (PDW) was 15.4(±3.3) fl. Mean platelet large cell ratio (PLCR) was 39.6(±8.9) %. Eight cases with MPV lower than 11fl and cases with PDW more than 15fl that were also having pancytopenia or bycytopenic picture were advised bone marrow aspiration for further diagnosis if clinically indicated. Six cases out of eight to whom bone marrow was advised were sent for bone marrow examination by the clinicians and we found that three of them were idiopathic thrombocytopenia and one Megaloblastic anemia, one case with pancytopenia due to hyperspleenism and one with acute leukemia with eosinophilia. Conclusion: From the above we concluded that all cases with MPV>11fl and PDW>14fl are sensitive and specific indicators for ITP and These indices help to distinguish hyper-destructive thrombocytopenia and hypo-productive thrombocytopenia very easily and it is also cost effective on a very simple test that is special smear. We must look for platelet indices very keenly while reporting a case with bi-cytopenia and pancytopenia.

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Platelet Counts and Indices Are Altered in Pre-Eclampsia

Annals of Pathology and Laboratory Medicine ◽

10.21276/apalm.2830 ◽

2020 ◽

Vol 7 (7) ◽

pp. A361-365

Author(s):

Vandana Saini ◽

Vijaya Vallepu ◽

Mamta Gupta

Keyword(s):

Platelet Count ◽

Prognostic Value ◽

Large Cell ◽

Endothelial Damage ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Cell Ratio ◽

Platelet Indices ◽

Platelet Counts

BACKGROUND: Endothelial damage and activation of platelets leading to their increased consumption and increase in production of young platelets by bone marrow is the most common pathophysiology of pre-eclampsia. Thus, fall in platelet count and altered platelet indices may have diagnostic as well as prognostic value in pre-eclampsia. AIM: To evaluate platelet count and platelet indices between pre-eclamptic and normotensive women and to assess their association with severity of pre-eclampsia. METHODS: Platelet counts and indices were estimated in 30 normotensive and 30 PE women at 20-24 weeks pregnancy and were repeated after every 4 weeks. RESULTS: Mean platelet counts, platelet volume, platelet distribution width, and platelet large cell ratio between pre-eclampsia and normotensive women were significantly altered in PE women and were associated with severity of PE. This alteration of platelet count and indices occurred even before the rise of BP. CONCLUSION: All the platelet indices were found to be reliable markers of PE and were found to be increased much earlier than BP. MPV had the maximum sensitivity (96.7%) and specificity (93.3%) and was the most reliable biomarker.

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Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia

British Journal of Haematology ◽

10.1111/j.1365-2141.2004.05357.x ◽

2005 ◽

Vol 128 (5) ◽

pp. 698-702 ◽

Cited By ~ 130

Author(s):

Ken Kaito ◽

Hiroko Otsubo ◽

Noriko Usui ◽

Miyuki Yoshida ◽

Jyunko Tanno ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Mean Platelet Volume ◽

Immune Thrombocytopenia ◽

Large Cell ◽

Platelet Volume ◽

Cell Ratio ◽

Platelet Size

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Mean Platelet Volume and Platelet Distribution Width as Markers in the Diagnosis of Acute Gangrenous Appendicitis

Disease Markers ◽

10.1155/2015/542013 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 9

Author(s):

Zhe Fan ◽

Jiyong Pan ◽

Yingyi Zhang ◽

Ziyi Wang ◽

Ming Zhu ◽

...

Keyword(s):

Mean Platelet Volume ◽

Medical Condition ◽

Roc Curves ◽

Disease Diagnosis ◽

Control Group ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Gangrenous Appendicitis ◽

Wbc Count

Introduction.Acute gangrenous appendicitis (AGA) is a common medical condition; however, the grade of appendicitis usually cannot be established preoperatively. We have attempted to identify some indicators, such as the mean platelet volume (MPV) and the platelet distribution width (PDW), to diagnose AGA.Aims.To evaluate whether or not the MPV and PDW are suitable markers to diagnose AGA.Methods.A retrospective study of 160 patients with AGA and 160 healthy patients was undertaken. Disease diagnosis was confirmed based on the pathologic examination of surgical specimens. Patient white blood cell (WBC) count, neutrophil ratio (NR), platelet (PLT) count, MPV, PDW, and hematocrit (HCT) were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of these indices in AGA.Results.There were no significant differences between the AGA and control groups in age and gender. Compared to the control group, the WBC count, NR, and PDW were significantly higher (P<0.001, resp.) and the MPV and HCT were significantly lower (P<0.001, resp.) in the AGA group. The diagnostic specificities of the WBC count, NR, PLT count, MPV, PDW, and HCT were 86.3%, 92.5%, 58.1%, 81.7%, 83.9%, and 66.3%, respectively. Therefore, the NR had the highest diagnostic specificity for the diagnosis of AGA.Conclusions.This is the first study to assess the MPV and PDW in patients with AGA. Our present study showed that the MPV is reduced and the PDW is increased in patients with AGA; the sensitivity of PDW was superior to the MPV. A decreased MPV value and an increased PDW could serve as two markers to diagnose AGA. The NR had the highest specificity for the diagnosis of AGA.

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Mean Platelet Volume and Platelet Distribution Width Correlate with Microvascular Complications in Egyptian People with Type 2 Diabetes Mellitus

Current Diabetes Reviews ◽

10.2174/1573399817666210608121024 ◽

2021 ◽

Vol 17 ◽

Author(s):

Mohammed I. Abd El-Ghany ◽

Nahed Abdallah ◽

Waleed Eldars

Keyword(s):

Type 2 Diabetes ◽

Mean Platelet Volume ◽

Microvascular Complications ◽

Fasting Blood Glucose ◽

Vascular Complications ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Diabetic Microvascular Complications

Background: Type 2 diabetes is a part of metabolic syndrome associated with a higher risk of vascular complications. Diabetes is characterized by changes in platelet morphology, function, and platelet hyperactivity so, it's considered a prothrombotic condition. Morbidity and mortality in people with type 2 diabetes-related to micro and macrovascular complications. Novel biomarkers are needed to identify and treat people at higher risk. Objective: The main objective of this controlled cross-sectional study was to evaluate Platelet volume indices (PVI) in subjects with type 2 diabetes with and without complications in comparison to subjects without diabetes. Methods: Hundred and thirty-five subjects aged from 35 to 60 years were subdivided into 3 groups. Group A includes 55 subjects with type 2 diabetes with complications. Group B includes 45 subjects with type 2 diabetes without complications. Group C includes 35 normal healthy subjects. Detailed clinical history was taken. Also, PVI, fasting blood glucose (FBG), hemoglobin A1c, and creatinine were obtained. Results: Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), and Platelet large cell ratio (P-LCR) were significantly higher among subjects with retinopathy, nephropathy, and neuropathy than other subjects with diabetes who didn't develop complications (P<0.001). At cutoff value > 11.9 fL, MPV have diagnostic sensitivity 80% and specificity 97.8%. Whereas PDW >16.9fL has a sensitivity of 74.5% and specificity of 100% for diabetic microvascular complications (retinopathy, nephropathy, and neuropathy). Conclusion: MPV and PDW may be considered as possible biomarkers for the early detection of diabetic microvascular complications.

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