Utility of platelet indices in diagnosing the underlying cause of thrombocytopenia due to accelerated platelet destruction

Aparna Pagidikalava,Nirvana Rasaily Halder,Sushma Yalavarthi

doi:10.21276/apalm.1717

Aparna Pagidikalava, Nirvana Rasaily Halder + Show 1 more

Open Access

https://doi.org/10.21276/apalm.1717

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Abstract

Background: Thrombocytopenia is a common clinical manifestation of many diseases and has numerous causes, including decreased bone marrow production, increased spleen sequestration, and accelerated destruction of platelets. Among the various aetiologies, Accelerated platelet destruction is the most common cause. Distinction between the various aetiological categories of thrombocytopenia is usually made by invasive bone marrow examination. Some studies stated that Platelet indices were altered in various causes of thrombocytopenia and helpful in discriminating the causes. we aim, to know the role of platelet indices in determining the underlying cause of thrombocytopenia due to platelet destruction.Methods: 30 Healthy controls and 145 patients (study group) with thrombocytopenia (platelet count <150x109) were included in the study. Thrombocytopenia due to decreased bonemarrow production and artefactual thrombocytopenia were excluded. The study group was divided into 3groups. Group 1 includes immune thrombocytopenia, Group 2 having thrombocytopenia of non immunological causes and Group 3 includes miscellaneous causes. Clinical features, Platelet counts and platelet indices were studied and statistical analysis was performed. Result: In all the groups of thrombocytopenia due to accelerated platelet destruction, MPV and P-LCR were significantly higher; P-LCC was significantly lower than healthy controls. There was no significant variation of PDW in NonImmune thrombocytopenia and miscellaneous groups, but PDW was significantly lower in immune thrombocytopenia than healthy controls.Conclusion: Platelet indices should be considered in the diagnosis of thrombocytopenia due to accelerated destruction of any cause. Among the platelet indices, PDW can be useful for a positive diagnosis of immunological thrombocytopenia.DOI:10.21276/APALM.1717

Highlights

Among the various pathogenetic mechanisms of thrombocytopenia, the most common mechanism is Accelerated destruction
Platelet indices should be considered in the diagnosis of thrombocytopenia due to accelerated destruction of any cause
platelet distribution width (PDW) can be useful for a positive diagnosis of immunological thrombocytopenia

Summary

Introduction

Among the various pathogenetic mechanisms of thrombocytopenia, the most common mechanism is Accelerated destruction. Platelet destruction most often is the result of extracorpuscular factors like immunological, non immunological and miscellaneous causes.[1] Platelet counts below normal values define thrombocytopenia but do not reveal the underlying pathomechanism. No consensus is reached regarding the necessity of a bone marrow examination in the evaluation of thrombocytopenia due to accelerated platelet destruction. Thrombocytopenia is a common clinical manifestation of many diseases and has numerous causes, including decreased bone marrow production, increased spleen sequestration, and accelerated destruction of platelets. Distinction between the various aetiological categories of thrombocytopenia is usually made by invasive bone marrow examination. We aim, to know the role of platelet indices in determining the underlying cause of thrombocytopenia due to platelet destruction Some studies stated that Platelet indices were altered in various causes of thrombocytopenia and helpful in discriminating the causes. we aim, to know the role of platelet indices in determining the underlying cause of thrombocytopenia due to platelet destruction

Methods

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Discussion

Conclusion