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Use of Platelet Indices in the Differential Diagnosis of Hypo-Productive and Hyperproductive Thrombocytopenia in Children

Pooja Agarwal, Assistant Professor, Department of Pathology, Rajshree Medical Research Institute, Bareilly, Uttar Pradesh 243122, India. , Pooja Agarwal

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Indian Journal of Pathology: Research and Practice 7(9):p 989-994, September 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7918.6

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Abstract

 Background: Platelets are essential for maintaining the integrity of the endothelium and for controlling hemorrhages when the injury to the blood vessels occurs. A low platelet count is a common entity encountered by the general pediatrician. Pediatricians then encountered with the problem of discriminating whether the low platelet count is caused by decreased production (hypoproductive thrombocytopenia) or increased destruction (hyper-productive thrombocytopenia). Material and Methods: The study population consisted of thrombocytopenic patients in the period between March 2017 and March 2018. A total of one hundred eighty patients (180) both female and male were enlisted, with age ranging from 1-14 years. Two groups were made to divide these patients, hyperproductive thrombocytopenia group (n=80) and hypo- roductive thrombocytopenic group (n=100). The automated cell counter with quality control and established reference ranges, was used to measure platelet count, mean platelet volume, and platelet distribution width. The sensitivity and specificity of mean platelet volume and platelet distribution width were calculated under various cutoff ranges for both thrombocytopenic conditions. Results: The sensitivity and specificity of platelet indices were calculated under various cut off  ranges. The MPV with a cutoff of >10.6fL detects 90% of the cases of ITP while excluding 86% of the hypo-productivesituations. When the chosen cutoff for MPV is greater than 12.6fL, detection rate was 50% of the ITP cases while excluding 94% of the hypo-productive cases. Conclusion: Results of the present study suggest that platelet indices are significantly higher in ITP patients compared to patients withhypo-productive thrombocytopenia. Comparing the sensitivity and specificity between MVP and PDW for both groups, PDW is moresensitive to detect the ITP patient than MVP but less specific in a cutoff above the normal range. 

Keywords: Platelet Indices; ITP; MPV; PDW

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7918.6

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