ROLE OF MEAN PLATELET VOLUME IN DIFFERENTIATING CAUSE OF THROMBOCYTOPENIA IN ADULTS: A STUDY FROM LAHORE, PAKISTAN

Abstract

Background: Thrombocytopenia is a common clinical problem characterized by a low platelet count. Mean platelet volume (MPV), an indicator of platelet morphology and maturity, has shown potential for diagnosing the etiology of thrombocytopenia. However, its use in clinical practice remains limited.Objective: The objective of this study was to investigate the correlation between MPV and the etiology of thrombocytopenia, aiming to determine its usefulness as a diagnostic marker. Methods: A study was conducted, involving 80 thrombocytopenic patients. Clinical diagnosis, platelet counts, and MPV values were recorded for each patient. Peripheral blood smears were examined for the presence of mega-platelets. Cases were categorized into Group A (Hypo- production etiology) or Group B (hyper-destructive etiology). Results: There is significant difference seen in MPV values in all groups. Group B (Over-destructive) comprised 40 cases, with 35 cases demonstrating an MPV value above 10.5 fl. The remaining cases in Group B, although not prominently raised, showed the presence of mega-platelets on peripheral blood smears. Group A (Under-production) included 40 cases, with 38 which were not associated with a high MPV value. Receiver operating characteristic curve analysis determined a cutoff MPV value of 8.5 fl, offering maximum sensitivity and specificity in distinguishing hyper-destructive thrombocytopenia cases from others. Conclusion:  MPV is an accurate platelet parameter that can aid in diagnosing the etiology of thrombocytopenia. It provides less invasive alternative to bone marrow examination for patients. Considering MPV, along with other platelet indices, may enhance diagnostic accuracy and patient management in thrombocytopenia cases.

Keywords: Thrombocytopenia, mean platelet volume, hyper-destruction, hypo-production, diagnostic marker.