Role of platelet indices in the evaluation of thrombocytopenia

Abstract

Background: Thrombocytopenia is defined as decrease in the count of platelets in circulating blood, so any alteration in count or function of platelets is potentially life-threatening. Evaluation of thrombocytopenia’s via platelet indices is safe and rapid procedure due to wide use of automated cell counters. In literature, there are few studies done on utilization of platelet indices in patients with thrombocytopenia due to accelerated destruction, thrombocytosis and in normal platelet count. This study is carried out to evaluate platelet indices in patients with thrombocytopenia(immune/non-immune/miscellaneous) and its role in decrease platelet productions and in accelerated platelet destruction.Materials and methods: This is a observational type of descriptive study done over a period of one year from April 2019 to March 2020. In this study, a total of 150 cases were evaluated with 75 healthy people in control group and 75 patients with thrombocytopenia in the study group. Assessment of complete blood count, Mean platelet volume (MPV), platelet distribution width(PDW), platelet large cell ratio (PLCR) and platelet large cell count (PLCC) was done on Beckman Coulter hematology analyser. In both control and study group, clinical features, platelet counts and platelet indices were analysed. The study group was further divided into hypo-proliferative and destructive thrombocytopenia sub-group depending on clinical and laboratory diagnosis and bone marrow studies in available cases. Result: The study group were further divided into hypoproliferative group and destructive group. Thrombocytopenia due to accelerated destruction includes 32 cases, whereas thrombocytopenia due to decreased production includes 34 cases in which megaloblastic group has 22 cases and non-megaloblastic group has 12 cases respectively. A total of 09 cases couldn’t be included in either groups and hence placed in miscellaneous group. The platelet count was not significantly different statistically between destructive and hypo-proliferative categories (p value =0.586).. Statistical comparison of the three platelet volume indices among various categories of thrombocytopenia was analysed. The MPV, PDW, PLCR and PLCC were significantly higher in megaloblastic group as compared to non-megaloblastic hypo-proliferative thrombocytopenia. Also, PDW was significantly lower in non-megaloblastic group as compared to both megaloblastic as well as destructive thrombocytopenia. Conclusion: Platelet indices in particular MPV and PLCR can discriminate hyper-destructive from hypo-productive thrombocytopenia. PDW can differentiate non-megaloblastic hypo-proliferative category from both the destructive and megaloblastic category of thrombocytopenia.