Abstract
<p>Background. Platelet-derived indices have a well-established correlation with the differential diagnosis of thrombocytopenia in adult-based research. These indices include mean platelet volume, platelet distribution width, and platelet-large cell ratio.</p><p>Objective. To determine the values of platelet-derived indices in a pediatric population with diagnoses of thrombocytopenia and their etiologic correlation.</p><p>Materials and methods. Analytic observational diagnostictest study. The population for this analytical study was pediatric patients between 6 months and 18 years of age who had thrombocytopenia (&lt;100x109/L). The study period was 18 months long.</p><p>Results. Of 54 subjects, 18 (33.3%) were diagnosed with idiopathic thrombocytopenic purpura, and 36 (66.7%) were diagnosed with acute leukemia. Mean age was 7.4 years and 6.8 years for immune thrombocytopenic purpura and acute leukemia, respectively. Mean platelet distribution width values for immune thrombocytopenic purpura and acute leukemia were 15.08 fL and 10.73, respectively. Mean MPV for immune thrombocytopenic purpura and acute leukemia was 11.7 fL and 9.8 fL, respectively. Mean platelet-large cell ratio was 38.26% and 24.97% for idiopathic thrombocytopenic purpura and acute leukemia, respectively. Differences in these three distinct platelet indices between idiopathic thrombocytopenic purpura and acute leukemia were statistically significant (p=0.00). The area under the ROC curve for platelet-derived indices showed that they were adequate for defining the causes of thrombocytopenia. MPV and platelet-large cell ratio had an area under the curve of 0.89 and 0.88, respectively, while platelet size deviation width had an area under the curve of 0.903.</p><p>Conclusions. Platelet-derived indices could be useful in the initial approach for the differential diagnosis of pediatric patients with thrombocytopenia.</p>
Highlights
mean platelet volume (MPV) and platelet-large cell ratio had an area under the curve of 0.89 and 0.88, respectively, while platelet size deviation width had an area under the curve of 0.903
Platelet-derived indices could be useful in the initial approach for the differential diagnosis of pediatric patients with thrombocytopenia
Among the studies that evaluate the usefulness of plateletderived indices for the differential diagnosis of the causes of thrombocytopenia, some can be found that show how mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) have a good diagnostic correlation when compared to findings from the study of bone marrow
Summary
Among the studies that evaluate the usefulness of plateletderived indices for the differential diagnosis of the causes of thrombocytopenia, some can be found that show how mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) have a good diagnostic correlation when compared to findings from the study of bone marrow. Among the studies carried out to determine differential diagnoses, it is worth mentioning thrombocytopenia secondary to disease of the bone marrow or to diseases that reduce platelet life-span [1,2], immune thrombocytopenic purpura and aplastic anemia [3,4,5], or thrombocytopenia due to megaloblastic anemia and other causes [6]. These studies have been performed on the adult population, but never on the pediatric population. These indices include mean platelet volume, platelet distribution width, and platelet-large cell ratio
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