Platelet indices: consideration in thrombocytopenia

Background There is increasing evidence that platelet indices, such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR), have a significant role in the discrimination between hyperdestructive thrombocytopenia and hypoproductive thrombocytopenia, and they can be of great help as they are routinely generated by automated cell counters. Objective In this study, we aimed to assess the sensitivity and specificity of these indices and set cutoff values that aid in the diagnosis of thrombocytopenia cause. Materials and methods We recruited 20 individuals as the control group and 80 thrombocytopenic patients, who were divided into two groups: group I ( n = 40) included newly diagnosed immune thrombocytopenic purpura (ITP) patients (hyperdestructive thrombocytopenia), whereas group II ( n = 40) included hypoproductive thrombocytopenia patients. The MPV and platelet distribution width were derived from automated cell counter results. The P-LCR was calculated. Results In ITP (hyperdestructive thrombocytopenia) patients, the MPV and P-LCR were significantly higher; the best cutoff value for MPV was greater than 9.7 fl and for P-LCR was greater than 33.6%, with a diagnostic accuracy of 70.1 and 99.6%, respectively. Conclusion The MPV and P-LCR provide information about the underlying conditions of thrombocytopenia. These indices should be considered in the diagnosis of thrombocytopenia. The P-LCR can be safely relied upon for a positive diagnosis of ITP.