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

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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Association of platelet count and platelet indices with cranial meningioma

Romanian Neurosurgery ◽

10.33962/roneuro-2020-017 ◽

2020 ◽

pp. 123-126

Author(s):

Yasar Karatas ◽

Fatih Keskin ◽

Mehmet Fatih Erdi ◽

Bulent Kaya ◽

Densel Arac ◽

...

Keyword(s):

Platelet Count ◽

Mean Platelet Volume ◽

Small Sample ◽

Control Group ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Healthy Group ◽

Platelet Indices ◽

Significant Difference

Introduction and Objectives: In this study, we aimed to investigate whether platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width (PDW) values can be used as diagnostic markers in cranial meningiomas. Materials and Methods: The study included results of 29 patient and 47 healthy contributors. Based on pathologies, the patients were divided into two groups. The first group included meningioma patients and the second one included healthy individuals. Healthy contributors named control group. Platelet count and platelet indices were determined using Sysmex XN 550 haematology analyzer. The preoperative platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width (PDW) values were recorded from the routine laboratory tests. Results: There was no statistically significant difference in PLT between the meningioma and healthy groups (p = 0.217). There was a statistically significant difference in PCT between the meningioma group and the healthy group (p = 0.002). There was a statistically significant difference in PDW between meningioma group and healthy group (p = 0.001). In terms of MPV, there was a statistically significant difference between meningioma group and the healthy group (p = 0.001) Conclusion: Platelet count and indices are easily available in the routine blood tests. Despite the retrospective design and small sample size, our findings suggest that altered MPV, PDW and PCT levels might serve as potential biomarkers for the diagnosis of meningiomas.

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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 indices evaluation in patients with dengue fever

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20182287 ◽

2018 ◽

Vol 6 (6) ◽

pp. 2054 ◽

Cited By ~ 4

Author(s):

Payal Mukker ◽

Smitha Kiran

Keyword(s):

Platelet Count ◽

Dengue Fever ◽

Mean Platelet Volume ◽

Dengue Infection ◽

P Value ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Platelet Indices ◽

Significant Difference

Background: Platelet indices (PIs)-Platecrit, mean platelet volume (MPV) and platelet distribution width (PDW)-are a group of platelet parameters obtained as a part of complete blood count using automated hematology analyzers. Evidence suggests that PIs may have diagnostic and prognostic value in febrile thrombocytopenia. This study aims to understand the profile of PIs in dengue fever. Aims and objectives was to study the platelet indices in patients with dengue fever.Methods: The present study is a retrospective observational study conducted in a tertiary hospital in Kerala. Platelet count, mean platelet volume (MPV), platecrit and Platelet distribution width (PDW) along with routine blood parameters hemoglobin(Hb), hematocrit, WBC, Platelet count, serum bilirubin, liver enzymes (AST, ALT) of 123 patients were collected. These 123 patients were grouped into three according to the platelet count (<20000,20000-100000, >100000). All the test results are available in hospital database. This was accessed using inpatient numbers obtained from medical records department of our institution. All analysis was done using free to use software R and values were rounded off to the nearest decimal point. Non normally distributed parameters were expressed as median (IQR). Parameters which did not follow normal distribution were analyzed with Kruskall Wallis test and the values are expressed as mean (SD) and a p value <0.05 was considered statistically significant.Results: Platelet indices PDW (57±13.8 vs. 55.4±6.9, p value 0.001) and MPV (9.2±0.09 vs. 13.8±1.3fL, p value <0.001) values were significantly altered in dengue fever with platelet counts below 20,000 compared to platelet count more than one lakh group. Similarly, the Platelet index (MPVxPDW\PLCxPCT), MPV\PLC, MPV\Platecrit, PDW\PLC and PDW\Platecrit ratio showed statistically significant difference between the different platelet groups.Conclusions: Platelet indices are useful parameters in dengue infection. Other than platelet count, PDW, MPV, platecrit are useful to monitor dengue fever.

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A pattern of platelet indices as a potential marker for prediction of pre-eclampsia among pregnant women attending a Tertiary Hospital, Ethiopia: A case-control study

PLoS ONE ◽

10.1371/journal.pone.0259543 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259543

Author(s):

Solomon Gebre Bawore ◽

Wondimagegn Adissu ◽

Berhanu Niguse ◽

Yilma Markos Larebo ◽

Nigussie Abebe Ermolo ◽

...

Keyword(s):

Platelet Count ◽

Pregnant Women ◽

Mean Platelet Volume ◽

Case Control Study ◽

Case Control ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Platelet Indices ◽

Control Study

Introduction Preeclampsia is the most serious health risk during pregnancy for both the mother and the fetus. Even though platelet parameters are among the proposed biomarkers for the prediction of preeclampsia, the use of its indices in the diagnosis of preeclampsia is not increasing in Ethiopia. There is little information on platelet patterns in preeclampsia and normal pregnancy. The purpose of this study was to determine the pattern of platelet indices in women with preeclampsia in our study setting. Methods A case-control study was conducted among 180 pregnant women who attended anti-natal follow-ups from January 1 to April 3, 2019. An Ethylene Diamine Tetra Acetic Acid anti-coagulated venous blood was collected and analyzed using a hematology analyzer (MINDRAY®-BC-300Plus, Shenzhen China). The SPSS software version 26 was used to run the Mann Whitney U test, Kruskal-Wallis H test, and Kolmogorov-Smirnov normality test, Post-hock test augmented with Benforeni, receiver operating characteristics curve, and Spear Man rank-order correlation. A P-value of <0.05 was considered statistically significant. Results A total of 180 pregnant women were included in the study. Platelet count and platelet crit levels tend to decrease as pre-eclampsia becomes more severe. In contrast, the mean platelet volume and platelet distribution widths were significantly increased with the severity of preeclampsia (P<0.001). Platelet distribution width (rho = 0.731, p<0.001) and mean platelet volume (rho = 0.674, p<0.001) had statistically significant positive relationships with mean arterial pressure. The best metric for predicting preeclampsia was platelet distribution width (AUC = 0.986; 95%CI; 0.970, 1). Conclusions Platelet indices, including platelet count, mean platelet volume, platelet distribution width, and Platelet crit, have been identified as promising candidate markers for predicting preeclampsia in pregnant women. In the future, a serial examination of these indicators during several trimesters of pregnancy should be conducted.

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RELATIONSHIP BETWEEN RED BLOOD CELL AND PLATELET INDICES IN IRON DEFICIENCY ANEMIA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.3904 ◽

2021 ◽

Vol 71 (2) ◽

pp. 575-78

Author(s):

Sahar Rabbani ◽

Muhammad Farooq ◽

Samina Naeem ◽

, Muhammad Abdul Naeem ◽

Nasir Uddin ◽

...

Keyword(s):

Blood Cell ◽

Cell Volume ◽

Red Blood Cell ◽

Mean Platelet Volume ◽

Large Cell ◽

Deficiency Anemia ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Cell Ratio

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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Mean Platelet Volume, Platelet Distribution Width, and Platelet Count in Varicocele: A Systematic Review and Meta-Analysis

Cellular Physiology and Biochemistry ◽

10.1159/000445579 ◽

2016 ◽

Vol 38 (6) ◽

pp. 2239-2246 ◽

Cited By ~ 11

Author(s):

Jung-Soo Pyo ◽

Won Jin Cho

Keyword(s):

Platelet Count ◽

Mean Platelet Volume ◽

Healthy Subjects ◽

Meta Analysis ◽

Mean Difference ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Platelet Indices ◽

Low Platelet Count

Background/Aims: The aim of this study was to elucidate the usefulness of platelet indices, mean platelet volume (MPV), platelet distribution width (PDW), and platelet count in diagnosis and monitoring of varicocele. Methods: The current study included 525 patients and 379 healthy subjects from five eligible studies. We performed meta-analysis of MPV, PDW, and platelet count and mean differences in these platelet indices between healthy subjects and varicocele patients. Results: The pooled MPVs were 8.168 fL (95% confidence interval [CI] 7.589 to 8.747) and 8.801 fL (95% CI 8.028 to 9.574) in healthy subjects and varicocele patients, respectively. The pooled mean difference in MPV between healthy subjects and varicocele patients was 0.834 fL in case-control studies (95% CI 0.195 to 1.473, P = 0.011). In both healthy subjects and varicocele patients, low platelet count subgroups showed higher MPV than high platelet count subgroups. The mean difference in MPV was higher in low platelet count subgroup. There was no significant difference in PDW between healthy subjects and varicocele patients. Conclusion: Taken together, our data showed that platelet count was significantly lower in varicocele patients than in healthy subjects. Varicocele patients showed significantly higher MPV and lower platelet count than healthy subjects. MPV levels of patients differed according to platelet counts.

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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 Indices As Markers For Remission In ALL During Induction of Remission: An Experience of 52 Cases

Bangladesh Journal of Child Health ◽

10.3329/bjch.v44i1.49685 ◽

2020 ◽

Vol 44 (1) ◽

pp. 34-39

Author(s):

Masuma Khan ◽

AKM Amirul Morshed ◽

Taslim Uddin Ahmed ◽

Hakimul Haque Khan ◽

Ashraf Uddin Ahmed ◽

...

Keyword(s):

Platelet Count ◽

Early Diagnosis ◽

Mean Platelet Volume ◽

Surrogate Marker ◽

Newly Diagnosed ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Platelet Indices ◽

Remission Phase

Background: Platelet indices (plateletcrit, mean platelet volume, platelet distribution width and Platelet count) are potentially useful markers for the early diagnosis and outcome of many diseases. Platelet indices could serve as surrogate marker for remission in patients with ALL. Objective: To observe change of platelet indices in ALL during induction of remission. Material & Methods: This observational study was carried out with 52 newly diagnosed ALL patients ranging from 1.5 to 12 years admitted at DMCH, from January to December 2015. Platelet indices such as plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PLT) were monitored from admission to induction of remission phase of chemotherapy and were analyzed. Result: Mean PLT was found 93442.3±29966.4 cmm before treatment, 137442.3±27217.9 cmm in 1st week and 231653.8±42543.5 cmm in 4th week. Mean PCT was found 0.09±0.11% before treatment, 0.16±0.11% in 1st week and 0.25±0.18 % in 4th week. Both PLT & PCT was increased significantly during induction of remission after one and four weeks. Mean PDW was found 13.1±3.9 fl before treatment, 12.9±3.5 fl in 1st week and 12.0±3.1 fl in 4th week. MPV was found 10.6±2.1 fl before treatment, 11.0±1.4 fl in 1st week and 10.7±1.4 fl in 4th week. The change of MPV & PDW were not statistically significant when compared with that of before treatment. Conclusion: It can be concluded that among four important platelet indices, PLT and PCT were significantly associated with remission in ALL during induction of remission. Bangladesh J Child Health 2020; VOL 44 (1) :34-39

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