Importance of platelet indices in the establishment of etiopathological categorization of thrombocytopenia in children

Abstract

BACKGROUND: Evaluation of thrombocytopenia requires thorough clinical history, examination, complete hemogram, including platelet indices and bone marrow study whenever indicated. The etiopathogenetic mechanism decides patient management. Platelet-derived indices have a well-established correlation with the differential diagnosis of thrombocytopenia in adult-based research. These indices include mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio. The aim of the present study is to evaluate the variation and relationship of platelet indices in hypoproductive and hyperdestructive thrombocytopenia in children. MATERIALS AND METHODS: A prospective, observational study for a period of 1 year was done on children with thrombocytopenia. Platelet count (PLT), PDW, MPV, and platelet-large cell ratio (PLCR) along with relevant clinical details of the thrombocytopenic patients were collected and tested for the statistical significance by the unpaired t-test. RESULTS: This study included 80 patients of thrombocytopenia who were classified into hypoproductive (40 cases) and hyperdestructive (40 cases). The mean PLT in hypoproduction group is 49.3 ± 27.8 × 109/l and in hyperdestruction group is 45.7 ± 35.4 × 109/l with a P value of 0.548. The MPV in hypoproduction group is 9.3 ± 0.5 fl and in hyperdestruction group is 12.5 ± 1.7 fl, with a statistically significant P value of 0.002. The mean PDW in hypoproduction group is 16.3 ± 2.3 fl and in hyperdestruction group is 17.7 ± 2.8 fl with a P value of 0.055. The PLCR in hypoproduction group is 27.57% ±3.57% and in hyperdestruction group is 39.65% ±3.53% with a P value of 0.0003. CONCLUSION: Platelet indices may provide useful information in discriminating the hypoproductive and hyperdestructive thrombocytopenia in children too. Interpretation of platelet indices can help the thrombocytopenic children in the initial management and can avoid invasive investigations.