Mean Values Of Mean Platelet Volume Research Articles

A Study of the Mean Platelet Volume and Plasma Fibrinogen in Type Two Diabetes Mellitus Patients Versus Healthy Controls and Their Role as Early Markers of Diabetic Microvascular Complications.

Background Mean platelet volume (MPV) is considered an emerging biological marker of platelet function and activity. Higher MPV has been scientifically linked to diabetes mellitus, metabolic syndrome, stroke, and coronary artery disease. Plasma fibrinogen is a circulating glycoprotein, serving as an acute inflammatory marker ultimately leading to enhanced atherogenic plaque formation. We conducted this study to evaluate the crucial role of MPV and plasma fibrinogen, which showed elevated levels in diabetes mellitus patients compared to non-diabetic healthy individuals. This study also elaborates on the pivotal role that MPV and plasma fibrinogen levels play in the pathogenesis of microvascular complications, which progress and eventually lead to mortality in patients with type 2 diabetes mellitus. Methodology This study is a single-center hospital-based study including120 type 2 diabetes mellitus patients and 120 healthy non-diabetic individuals. It is across-sectional and observational study. The study wasconductedover a period of one and a half years in a medical college and hospital in a semi-urban locality in Western Maharashtra, India. We obtained informed written consent from the patients. All patients underwent thorough clinical assessment, and data were collectedusing proformas, which were latertabulated and entered in Microsoft Excel sheets. Later, the statistical data analysis was performed.Plasma fibrinogen was performed by photo-optical clot detection. MPV was analyzed by coulter principle in the central laboratory department of the parent institute. Patients above 18 years with cases of type 2 diabetes mellitus with or without any related complications, while the controls are healthy non-diabetic individuals attending the outpatient and inpatient departments of General Medicine. We excluded patients under the age of 18 years, those diagnosed with type 1 diabetes mellitus, hematological conditions associated with anemia and abnormal platelet counts, pregnant females, any acute or chronic infections, patients currently on antiplatelet medication and other drugs affecting the platelets, and all critical patients. Results The majority of patients in our study were in the age group of 41-50 years, with 49.2% having one or more microvascular complications of diabetes mellitus. In our study, out of 120 cases, 3.3% and 23.3% had raised MPV and fibrinogen levels, respectively, above the normal range. When compared with males and females, there was no statistically significant difference in the mean value of MPV and fibrinogen. On the t-test (p < 0.05), there was a statistically significant difference in the mean value of MPV and fibrinogen level between diabetics with and without microvascular complications. The t-test (p < 0.05) showed that there was a statistically significant difference among cases in the mean values of MPV and plasma fibrinogen in relation to retinopathy, nephropathy, and neuropathy, which are all microvascular complications of diabetes. Conclusion The study reveals higher levels of MPV and fibrinogen in diabetic patients compared to non-diabetic healthy individuals. In addition,higher levels of MPV and fibrinogen were present in patients with microvascular complications, correlated with age and diabetes duration.

Prognostic Potential of Thrombocyte Indices, Acute Phase Proteins, Electrolytes and Acid-Base Markers in Canine Parvovirus Infected Dogs With Systemic Inflammatory Response Syndrome

Dogs with canine parvovirus enteritis (CPVE) that develop systemic inflammatory response syndrome (SIRS) frequently have a poor prognosis. The aim of the study was to assess the prognostic potential of thrombocyte indices, acute phase proteins, electrolytes, and acid-base markers in CPVE puppies with SIRS (CPVE-SIRS+) at admission. A case-controlled, prospective, and observational study was performed on 36 CPVE puppies. Mean concentrations of C-reactive protein (CRP), albumin, thrombocyte count, mean platelet volume (MPV), platelet distribution width (PDW), sodium (Na+), potassium (K+), chloride (Cl−) and ionized calcium (iCa) were measured and strong ion difference 3 (SID3), ATOT-albumin and ATOT-total protein were determined in CPVE-SIRS+ survivors and nonsurvivors. A prognostic cut-off value for predicting the disease outcome was determined by receiver operating characteristic (ROC) curve analysis. The mean values of MPV, PDW and CRP were significantly higher and the mean values of albumin, Cl− and ATOT-albumin were significantly lower in CPVE-SIRS+ nonsurvivor than CPVE-SIRS+ survivor puppies on the day of admission, but the thrombocyte count, Na+, K+, iCa, SID3 and ATOT- total protein values did not differ significantly. The positive predictive values (PPVs) for survival using cut-off value of MPV (≤15.08 fL), PDW (≤14.85%), CRP (≤180.7 mg/L), albumin (≥1.795 g/dL), Cl− (≥96.00 mmol/L), and ATOT-albumin (≥7.539) were determined as 100%, 100%, 100%, 80%, 100%, and 80%, respectively with better area under ROC curve and sensitivity. Based on sensitivity, specificity, and PPVs from ROC analysis, it is concluded that the determination of Cl− concentration and MPV at admission followed by CRP will serve as the most appropriate biomarkers in predicting the disease outcome of CPVE puppies that develop SIRS.

Relationship of mean platelet volume in predicting severity in hypertensive retinopathy – A cross sectional study

Background: Hypertension is a major health issue in India and it has led to increasing incidences of target organ damage including hypertensive retinopathy (HR). Many factors like platelet activation show influence in levels of HR. Mean platelet volume (MPV) being an indicator of platelet activation can help in predicting the severity of HR. The present study was planned to find a correlation of levels of MPV with the severity of HR. Methodology: Data of 100 cases of hypertensive retinopathy aged 31 to 80 years diagnosed by direct and indirect ophthalmoscopic examination in the outpatient department of ophthalmology was recorded and reviewed. Complete clinical and demographic data (age, gender, weight, body mass index and socioeconomic status) was noted. Mean platelet volume was obtained from fully automated haematology analyser Horiba medical Yumizen H550. Results: The mean age (years ± standard deviation) of cases with grade 1 HR was 59.448±11.642, grade 2 HR was 56.166±10.0377 and grade 3 HR was 58±19.37. The mean value of MPV in the study population for grade 1 HR was 8.55±0.576, for grade 2 HR was 9.17±0.8224, for grade 3 was 9.6±1.5594. The comparison between grades of HR and levels of MPV was done by one way analysis of variance. Conclusion: We established a significant relationship between mean platelet volume and severity grades of hypertensive retinopathy. MPV a cheap and easily available biomarker can be used for predicting severity in hypertensive retinopathy.

Transthyretin, Immature Platelet Fraction, and Mean Platelet Volume in Normotensive and Preeclampsia Pregnancy

BACKGROUND: Transthyretin protein experiences misfolding and aggregation in preeclampsia due to placental ischemia and inflammation. Placental endothelial damage occurring in preeclampsia stimulates the production of larger young platelets in the bone marrow and can be reflected by an increase in the immature platelet fraction (IPF) and mean platelet volume (MPV). Since the change in these markers in preeclampsia remains controversial, this study was conducted to analyze the differences in levels of transthyretin, IPF, and MPV as easily accessible markers in normotensive and preeclampsia pregnancies.METHODS: Total subjects included in this study were 32 normotensive and 26 preeclampsia pregnant woman. The measurement of serum transthyretin level was using enzyme-linked immunosorbent assay (ELISA) method. Meanwhile, IPF and MPV levels were measured by using a hematology analyzer with flowcytometry method. Data was statistically analyzed using unpaired T-test and Mann-Whitney, with significancy of p&lt;0.05.RESULTS: Median value of transthyretin in normotensive and preeclampsia pregnancy were 11 (6-30) mg/dL and 9 (5-18) mg/dL. The mean value of IPF in normotensive and preeclampsia pregnancy were 4.56±2.19% and 6.33±2.99%. Mean value of MPV in normotensive and preeclampsia pregnancy were 10.41±0.76 fL and 11.32±1.2 fL. There were significant differences in levels of transthyretin, IPF, and MPV between normotensive and preeclampsia pregnancies (p=0.008, p=0.017, and p=0.002, respectively).CONCLUSION: There are significant differences in transthyretin levels, IPF, and MPV values in normotensive and preeclampsia pregnancies. Therefore, serum transthyretin, IPF, and MPV can be developed as affordable parameters for the diagnosis of preeclampsia.KEYWORDS: preeclampsia, transthyretin, IPF, MPV

Predictive value of prognostic factors at multiple trauma patients in intensive care admission

Purpose We aimed to evaluate the relationship between trauma patients' mortality and neutrophil/lymphocyte ratio (NLR) at intensive care units admission. Methods We examined 107 ICU trauma patients. Patients were divided into two groups as those who survived (Grup I) and deceased (Grup II). Patients' age, NLR, mean platelet volume (MPV), lactate value, length of stay in the intensive care unit, acute physiology and chronic health evaluation 2 (APACHE II) scores were examined. The effects of these factors on mortality were examined. Results 83 (77.58 %) patients were male, 24 (22.42 %) patients were female. The patients' mean age was 46.89 ± 19.06 years. The mean value of the lactate level was 3.25 ± 2.92, the mean value of MPV was 10.34 ± 1.02, the average value of NLR was 8.23 ± 8.11, the average score of APACHE II was 22.8 ± 8.75, and the average length of stay in the ICU was 11.33 ± 22.98 days. The relationship with mortality was evaluated between the groups, there was a statistically significant difference in APACHE II scores. There was no statistically significant difference between other variables. Conclusions NRL, MPV, lactate levels were not suitable for the evaluation of trauma patients as an early prognostic factor like APACHE II during admission to ICU (Tab. 2, Fig. 1, Ref. 23).

Relationship of Mean Platelet Volume and HbA1c in Predicting the Level of Diabetes Control in Type 2 Diabetes Mellitus

Background: MPV is an indicator of platelet size and MPV is increased in DM as compared to non-diabetics, more so in presence of complications. There are few studies evaluating the association between MPV and HbA1c and its role in predicting glycaemic control with conflicting results. The present study was planned to determine the relationship between MPV and HbA1c in predicting the level of diabetes control in type 2 DM. Methodology: Cross sectional observational study including 100 consecutive cases of type 2 DM aged between 30 to 60 years. Mean platelet volume (MPV), platelet distribution width (PDW) and platelet count were obtained from fully automated haematology analyser Sysmex KX-21. Glycosylated haemoglobin (HbA1c) was analysed by automated haemoglobin analyser. Results: The mean age among 100 type 2 DM cases was 49.58 ± 14.49 years. The mean value of MPV and HbA1c was 10.25±0.90fl and 5.66± 1.17% respectively. There was no significant correlation found between MPV and HbA1c (r=0.110, p=0.275). Similarly, there were no significant association between MPV and three levels of glycaemic control. Conclusion: MPV is not a reliable marker for determining glycaemic control in type 2 DM.

The relationship between platelet volume and risk of atherosclerosis in patients with psoriasis

Objective The aim of this research was to evaluate the relation between the mean platelet volume (MPV) and clinical aspects (onset, duration, and severity) in patients with psoriasis. In addition, the purpose was to evaluate the possible risk of atherosclerosis in these patients. Background Psoriasis is an inflammatory skin disease affecting 2–4% of the world population. However, studies in developing countries have reported higher prevalence rates of ∼4.6% on an average. MPV is an indicator of platelet activation, and it is a newly emerging risk factor for patients with atherothrombotic psoriasis. Patients and methods A case–control study was conducted on 40 patients with variable degrees of psoriasis severity (cases) and they were compared with 20 matched healthy participants (controls). All participants were selected from dermatology inpatients and outpatient clinics of the Menoufia University Hospital in the period from September 2015 to March 2016. Full detailed history, routine laboratory investigations, clinical features, Psoriasis Area and the Severity Index (PASI) scores, and carotid intima-media thickness (CIMT) and nonalcoholic fatty liver disease (NAFLD) values were taken for each participant (cases and controls). Results There were statistically no significant differences between patients with psoriasis and control groups regarding age, sex, BMI, total cholesterol, and triglycerides (P>0.05%, for all), whereas patients with psoriasis had significantly higher systolic and diastolic blood pressure, fasting plasma glucose, mean MPV and CIMT values, and frequency of ultrasound-diagnosed NAFLD than the control group. In addition, BMI, duration of illness, PASI, and mean values of MPV were significantly (P=0.5) elevated in patients with psoriasis with atherosclerosis than patients with psoriasis without atherosclerosis. Moreover, MPV level was correlated positively with age, BMI, duration of psoriasis, PASI score, and CIMT in the atherosclerotic psoriatic case group. Moreover, CIMT and PASI score were correlated positively with BMI, duration of illness, MPV, systolic blood pressure, diastolic blood pressure, glycated hemoglobin, and NAFLD in the psoriasis patient group, whereas CIMT was significantly correlated positively with PASI score. Conclusion Psoriasis is associated with high MPV. So, MPV is a good indicator of psoriasis severity. Thus, MPV is a good positive test for early detection of premature atherosclerosis in patients with psoriasis. This study may confirm previous observation indicating increased platelet activation in psoriasis. Increased platelet activity could contribute toward increasing the atherosclerotic risk in patients with psoriasis.

Lack of association between platelet indices and disease stage in osteosarcoma at diagnosis.

PurposeThe purpose of this study was to investigate the relationship between platelet indices [mean platelet volume (MPV), platelet count (PLT), platelet distribution width (PDW) and plateletcrit (PCT)] at diagnosis in osteosarcoma.MethodsThe information of 233 patients with osteosarcoma at diagnosis between 2007 and 2015 was retrospectively reviewed. Clinical parameters such as gender, age, size and site of tumor, and tumor necrosis rate after neoadjuvant chemotherapy were analyzed.ResultsNo significant difference was noted in the mean values of MPV, PLT, PDW and PCT among stage I, II and III patients. In localized patients, the median disease-free survival (DFS) values were 42 and 22 months in the PLT<300×109/L and ≥300×109/L groups, respectively, but the difference was not statistically significant (P = 0.2611). No difference in the DFS among the three different levels of MPV was observed.ConclusionNo significantly different platelet indices were noted among the different stages. Although a shorter median DFS was found in localized patients with PLT≥300×109/L, there was still a lack of strong evidence to demonstrate the association between platelet indices and osteosarcoma.

PS-095a The Mean Platelet Volume In Infants With Meconium Stained Amniotic Fluid

Background and aims To investigate the association between serum mean platelet volume (MPV) levels and meconium stained amniotic fluid (MSAF). Methods MPV, serum reactive protein and haemoglobin levels, leukocyte and thrombocyte counts were measured in 106 infants with MSAF and 78 healthy control infants for comparison. Demographic factors including gestational age, birth weight, gender, delivery mode, parity, maternal pregnancy diseases, intrauterine infections, maternal smoking and severity of meconium aspiration syndrome were recorded. Results The mean values of MPV in infants with MSAF were significantly lower than in the control group statistically (p 0.05). There was no statistically significant difference in MPV levels in the infants with meconium aspiration syndrome (MAS) compared to the study group (p > 0.05). A 9.90 fl [area under the curve (AUC: 0.788)] optimal cutoff value of MPV with a sensitivity of 78.1% and specificity of 74.3% was determined in infants with MSAF. Conclusions Our data suggest that the MPV levels were significantly lower in infants with MSAF than that in healthy infants. This might be associated with hypoxic process. However, the MPV levels were statistically similar between MSAF and MAS, leading to a failure of detecting patients with or without severe disease.

Functional characterization of platelets in patients with arterial erectile dysfunction.

Arterial erectile dysfunction (ED) is commonly associated with classic cardiovascular and metabolic risk factors, such as smoking, hypertension, diabetes mellitus, dyslipidaemia and obesity. However, some patients with arterial ED do not present any cardiovascular risk factor. As mean platelet volume (MPV) has been shown to be directly related to the cardiovascular risk and the percentage of platelets expressing the vitronectin receptor (αVβ3), involved in the early stages of platelet adhesion, is higher in patients with ED, the present study was undertaken to evaluate MPV and αVβ3 in 15 patients with arterial ED not associated with any cardiovascular risk factor. Their MPV and αVβ3 values were compared with those of men with normal penile haemodynamic. Patients with arterial ED had a mean value of MPV (11.25 vs. 9.88 fL; p < 0.001) and a percentage of platelets expressing the αVβ3 (7.39 vs. 2.07%; p < 0.001) significantly higher compared to controls. A negative correlation was observed between peak systolic velocity and MPV (r = 0.916; p < 0.001) or αVβ3 (r = 0.930; p < 0.001), whereas MPV and αVβ3 correlated positively (r = 0.908; p < 0.001). In conclusion, this study showed for the first time that MPV and the percentage of platelet expressing αVβ3 are significantly higher in patients with arterial ED compared to controls. We speculate that these parameters of platelet function may be envisaged as markers of cardiovascular risk in patients with arterial ED.

The correlation between red blood cell distribution width levels with the severity of obstructive sleep apnea and carotid intima media thickness.

BackgroundObstructive sleep apnea syndrome (OSAS) is characterized by repetitive collapse of the upper airway during sleep. Red blood cell distribution width (RDW) increases platelet activation and has been reported as an independent predictor of adverse outcomes in the general population and is believed to be associated with cardiovascular morbidity and mortality. We evaluated RDW, mean platelet volume (MPV), and platelet distribution width (PDW) as a severity index in OSAS and the relationship between carotid intima media thickness and pulmonary hypertension.Material/MethodsThe study population consisted of 99 patients who were admitted to the sleep laboratory. Based on the apnea-hypopnea index, patients were grouped into 3 OSAS severity categories. Morning blood samples were withdrawn from patients after a 12-hour fasting period. MPV, PDW, and RDW were measured in a blood sample. Bilateral common carotid arteries of the patients were scanned.ResultsNinety-nine patients – 73 with OSAS and 26 simple snoring control cases – were included. Mean values of MPV, PDW, and RDW were similar in patients compared to simple snoring subjects in the control group (p=0.162, p=0.656, p=0.091). RDW showed an inverse correlation with mean desaturation and lowest desaturation (p<0.01). Body mass index, apnea-hypopnea index, pulmonary artery pressure, and desaturation time under 90% were positively correlated with RDW (p<0.05). MPV, PDW, and carotid intima media thickness had no correlation with any other parameters.ConclusionsThe study showed a positive relationship between RDW and the apnea-hypopnea index and systolic pulmonary hypertension in patients with OSAS.

Can platelet indices predict obstruction level of pulmonary vascular bed in patients with acute pulmonary embolism?

Computed tomography pulmonary arterial obstruction index ratio (CTPAOIR) is related with the severity of pulmonary embolism (PE). Platelet indices including mean platelet volume (MPV), platelet distribution width (PDW) are reported to be increased in acute PE. In this study, we aimed to evaluate the relationship between CTPAOIR and platelet indices and the utility of these parameters in the determination of PE severity. We retrospectively analysed the demographic data, clinical probability scores, laboratory data and echocardiographic findings of 63 acute PE patients who were diagnosed by pulmonary arterial computed tomography angiography. The hospital records of 38 (60.3%) male and 25 (39.7%) female patients with acute PE and 29 (58%) male and 21 (42%) female healthy control were evaluated (P = 0.803). The mean value of MPV, PDW levels, platelet counts and red cell distribution width levels were higher in PE groups than in control subjects (P < 0.05). Massive PE was present in 33.3% of PE patients. There were statistically significant differences in terms of hospital length of stay (HLS), mean value of MPV, CTPAOIR and systolic pulmonary arterial pressure (sPAP) in addition to systolic arterial pressure between massive and submassive PE patients (P < 0.05 for all). CTPAOIR was positively correlated with HLS, clinical probability scores, D-Dimer level, MPV, PDW levels and sPAP. Platelet indices, MPV and PDW, can be used for the determination of disease severity, and lead to therapeutic strategies for PE patients.

The Comparison of Platelet Parameters in Patients with Thrombocytopenia Associated with Acute Myeloid Leukemia and Immune Thrombocytopenia

AbstractAbstract 3317Parameters associated with platelets (PLT) other than total PLT count, mean platelet volume (MPV), and platelet distribution width (PDW) are not widely used in clinical fields, although recent researches about them are increasingly reported. Additional platelet parameters can be helpful to evaluate the underlying cause of thrombocytopenia induced by two mechanisms-insufficient production and destruction of platelets. We investigated the significance of platelet parameters by evaluation of patients with ineffective platelet production (acute myeloid leukemia, AML) and destruction of platelets (immune thrombocytopenia, ITP).49 adults newly diagnosed with AML (median age: 60, range: 21–86 years old) who had thrombocytopenia (<150 ×103/uL) and 47 adults with ITP (median age: 44, range: 22–82 years old) who were diagnosed with the bone marrow (BM) study were retrospectively reviewed. PLT and PLT parameters - MPV, PDW, PLT crit (PCT), mean PLT component (MPC), mean PLT mass (MPM), and large PLT count (LPLT) were measured by the ADVIA 2120 Hematology System (Siemens, USA) at the time of diagnosis. The percentage of LPLT (LPLT%) was calculated (LPLT/PLT ×100). The mean values of each group were compared using independent T-test on SPSS. The sensitivity and the specificity of each item to differentiate AML and ITP were determined by receiver operating characteristic (ROC) curve analysis.The mean values of platelet parameters of 480 male and female Korean adults in different age groups (120 in each group) who had hemoglobin level of 12–16.5 g/dl in female and 13–18.5 g/dl in male, white blood cell count of 4–10 ×103/ul, and PLT of 150–450 ×103/ul are shown in table I. The mean values of MPV, PDW, MPC, MPM, and LPLT% of ITP patients were significantly higher than those of AML (p<0.05). PLT, PCT, and LPLT did not show the difference between AML and ITP patients (Table II). Also, MPV, PDW, MPC, MPM, and LPLT% appeared significant to differentiate two diseases (p<0.05) upon ROC curve analysis (Table III).Table IPlatelet parameters in 480 Korean adultsPlatelet parametersMean ¡¾ SDTotalMale under 50YMale over 50YFemale under 50YFemale over 50YReference rangePLT (×103/¥ìl)261 ¡¾ 53257 ¡¾ 52241 ¡¾ 47259 ¡¾ 51280 ¡¾ 59150–450MPV (fl)7.9 ¡¾ 1.07.7 ¡¾ 0.77.9 ¡¾ 0.77.9 ¡¾ 0.78.0 ¡¾ 1.89–13PDW (%)51.3 ¡¾ 7.551.6 ¡¾ 7.552.1 ¡¾ 7.152.2 ¡¾ 5.849.0 ¡¾ 9.0NPCT (%)0.20 ¡¾ 0.040.20 ¡¾ 0.040.19 ¡¾ 0.040.20 ¡¾ 0.060.20 ¡¾ 0.04NMPC (g/dl)26.0 ¡¾ 1.326.2 ¡¾ 1.425.8 ¡¾ 1.326.4 ¡¾ 1.025.5 ¡¾ 1.5NMPM (pg)1.9 ¡¾ 0.21.9 ¡¾ 0.21.9 ¡¾ 0.22.0 ¡¾ 0.21.9 ¡¾ 0.2NLPLT (×103/¥ìl)4.7 ¡¾ 2.74.5 ¡¾ 2.74.6 ¡¾ 3.14.9 ¡¾ 2.34.7 ¡¾ 2.8NLPLT% (%)1.7 ¡¾ 0.61.8 ¡¾ 1.32.0 ¡¾ 1.42.0 ¡¾ 1.11.8 ¡¾ 1.2NAbbreviations: SD, Standard deviation; Y, years old; N, Not determined; see text.Table IIPlatelet parameters in AML and ITP patientsPlatelet parametersDiseaseMean ¡¾ SDReference rangePLT (×103/¥ìl)AML59 ¡¾ 35150-450ITP54 ¡¾ 29MPV* (fl)AML9.8 ¡¾ 2.19–13ITP10.9 ¡¾ 2.8PDW* (%)AML53.9 ¡¾ 17.0NITP60.6 ¡¾ 12.1PCT (%)AML0.06 ¡¾ 0.04NITP0.06 ¡¾ 0.03MPC* (g/dl)AML22.3 ¡¾ 2.1NITP25.4 ¡¾ 2.2MPM* (pg)AML2.0 ¡¾ 0.3NITP2.4 ¡¾ 0.4LPLT (×103/¥ìl)AML3 ¡¾ 5NITP4 ¡¾ 6LPLT%* (%)AML4.7 ¡¾ 5.2NITP8.3 ¡¾ 9.4Abbreviations: See table I; see text.*p<0.05.Table IIIAUC for differentiation of AML and ITP with cut-off values¡¡AUC (95% CI)Cut-off valueSensitivity (%)Specificity (%)PLT0.48 (0.36–0.59)68 ×103/¥ìL34.074.6MPV*0.66 (0.55–0.77)10.2 fL57.478.0PDW*0.63 (0.53–0.74)56.3 %66.069.5PCT0.51 (0.40–0.62)0.07 %40.472.9MPC*0.84 (0.78–0.92)2.1 g/dL87.276.3MPM*0.85 (0.75–0.91)22.5 pg78.776.3LPLT0.61 (0.50–0.71)5.5 ×103/¥ìL21.389.8LPLT%*0.67 (0.57–0.77)4.1 %72.361.0Abbreviations: AUC, areas under the curves; CI, confidence interval; see text.*: p<0.05.In AML, deficient platelet production in the BM causes thrombocytopenia. Immune mediated destruction in the peripheral blood induces thrombocytopenia in ITP in spite of activated PLT production in BM. MPV, PDW and platelet large cell ratio (P-LCR measured by Sysmex-XE2100) had been reported to reflect production rate (MPV and PDW) and percentage of immature platelets (P-LCR) so that being higher in ITP than aplastic anemia (Kaito et al, 2004). MPV, PDW, MPC, MPM, and LPLT% were higher in ITP than AML in our study. They are also proven to differentiate AML and ITP upon ROC curve analysis. MPV, PDW, and LPLT% can be used as markers to predict the status of thrombopoiesis differentiating two mechanisms of thrombocytopenia, deficiency of production and destruction of platelets. Disclosures:No relevant conflicts of interest to declare.

Plasma thrombopoietin level and platelet indices in hemodialysis patients receiving recombinant human erythropoietin

We focused on thrombocytopenia in hemodialysis patients (HD) receiving recombinant human erythropoietin (rHuEPO) and investigated thrombopoietin (TPO) level and platelet indices. We analyzed platelet parameters including mean platelet volume (MPV), platelet-crit (PCT), mean platelet component (MPC) concentration and platelet count (PLT) using ADVIA 2120 in 375 HD patients. This study included 25 HD patients undergoing treatment with rHuEPO at 9000 IU/week. These patients were divided into two groups by reference PLT of 130 x 10(9)/l [eight patients with low PLT (L-PLT group) and 17 patients with normal PLT (N-PLT group)], and TPO level and platelet indices in each group were compared with those in nine HD patients not receiving rHuEPO. In HD patients, the mean value of MPV was slightly higher and the mean values of PLT, PCT, and MPC were significantly lower than those in healthy controls. TPO levels were significantly higher in patients receiving rHuEPO than in patients not receiving rHuEPO. However, no significant difference was found between TPO levels in patients in the L-PLT group and patients in the N-PLT group. TPO levels were not correlated with PLT in these patients and that MPC levels decreased remarkably regardless of PLT.

Association of Mean Platelet Volume With The Degree of Retinopathy in Patients with Diabetes Mellitus

Aim: We investigated the association of mean platelet volume (MPV) with the degree of retinopathy in patients with diabetes mellitus (DM). Methods: Ninety patients with diabetic retinopathy (DRP) and 30 healthy individuals were included in the study. Diabetic patients included 30 background, 30 non-proliferative and 30 proliferative diabetic retinopathy cases. Complete blood count, intra- and intergroup comparisons of MPV values were performed. Results: Mean values for MPV in patients with background, nonproliferative and proliferative DRP were 7.76±0.72 fL, 7.94±0.61 fL and 8.18±0.89 fL, respectively. MPV values of patients with background DRP was not significantly different from that of the control group and patients with non-proliferative and proliferative DRP as well. However, MPV values of patients with proliferative DRP were significantly higher than the values of control group (p< 0.05). A significant correlation was found between the degree of retinopathy and mean values of MPV in diabetic patients (r= 0.214, p< 0.05). Conclusions: We found an association between the degree of retinopathy and mean values of MPV. This finding suggests a role for platelets in the pathogenesis of vascular complications and that mean platelet volume would be useful in monitoring the disease progression.

Mean Platelet Volume in Children with Sickle Cell Disease on Chronic Transfusion Therapy.

The symptoms in sickle cell disease are related to ischemic/vaso-occlusive episodes involving the bones, spleen, brain and lungs. One of the possible mechanisms for vaso-occlusion is platelet activation and increased platelet reactivity which is demonstrated by increased platelet volume resulting in an elevated platelet distribution width. We hypothesized that chronic transfusion therapy given to patients with recurrent severe ischemic episodes and/or stroke may lower mean platelet volume (MPV) in addition to decreasing hemoglobin S. We performed a retrospective chart analysis of all patients with sickle cell disease who were on a chronic transfusion regimen at Schneider Children's Hospital between January 1995 and March 2005. Out of 60 eligible patients, only 42 were eligible for this study. The remaining patients were excluded for less than 3 transfusions in total or incomplete records. The data retrieved included age and sex of the patient, type of sickle cell disease, indication for chronic transfusion therapy, duration of transfusions and blood count variables during the three phases, i.e. prior to, during and after transfusion therapy. The variables included hemoglobin, mean cellular volume, platelet count, reticulocyte count and MPV for each patient with a minimum of one value in each phase. As many values were recorded based on the availability in the records, with at least an interval of 3 months between each blood count and at least 3 months apart from a transfusion.Results: Sixty-four percent were males and 95% had HbSS genotype. The major indication for transfusion therapy (85%) was stroke. Mean values of each variable and their ranges were compared across the 3 periods using the Kruskal Wallis test. Although the platelet count decreased significantly during transfusions compared to pre-transfusion period, the mean value of MPV did not differ across the 3 periods with a range between 5.9 and 11.3 in all the 3 periods. Furthermore, using the Anacova method proposed by Bland and Altman, there was an overall significant negative correlation between MPV and platelet count, while no correlation at all was present between MPV, reticulocyte count and hemoglobin in any of the 3 periods. Our findings suggest that multiple transfusions do not alter platelet size or volume, which indirectly may indicate that there is no change in platelet function or activity in these patients on chronic transfusion therapy. The changes in MPV values seen in this study are real, as they follow the natural thrombokinetics by maintaining a negative correlation with the platelet count during all 3 periods.