Clinical Significance of Platelet Parameters in the differential diagnosis of thrombocytopenia

INTRODUCTION: Bone Marrow (BM) examination is the gold-standard test in discriminating between hyperdestructive thrombocytopenia and hypoproductive thrombocytopenia. However, BM examination is an invasive, time-consuming, and expensive approach. Therefore, BM study is not recommended as the first-line method. Recent studies showed that platelet parameters such as mean platelet volume (MPV), plateletcrit (PCT), platelet size deviation width (PDW) could be used for differential diagnosis of thrombocytopenia. In the present study, accordingly, we aimed to investigate the significance of these parameters in the differential diagnosis of thrombocytopenia.
METHODS: One hundred sixty-four (164) patients with thrombocytopenia were included in the present study. The patients were divided into two groups according to the time of the diagnosis of thrombocytopenia: hyperdestructive (75 ITP) and hypoproductive (25 AA, 25 MDS, 24 AML, 15 ALL). The diagnosis was made based on hematological, pathological, and chromosomal analyses and guidelines. Samples for complete blood counts were collected in K3EDTA tubes and analyzed with an automated hematology analyzer, Beckman-Coulter.
RESULTS: The platelet count was similar in both groups. The present results showed that there were no statistically significant differences between the groups in terms of age, gender and PDW. However, MPV was significantly higher in the hyperdestructive group than the hypoproductive group. By contrast, PCT was considerably lower in the hyperdestructive group than the hypoproductive group.
DISCUSSION AND CONCLUSION: The results of the present study indicated that these platelet parameters might provide additional contributions to strengthen the diagnosis in patients diagnosed with ITP and would be beneficial to consider the thrombocyte parameters as well as the clinical and other laboratory tests of the patient.

Trombositopeninin ayýrýcý tanýsýnda Trombosit Parametrelerinin Klinik Önemi

GÝRÝÞ ve AMAÇ: Hipoprodüktif (örn: AA, AML, ALL, MDS) ve hiperdestrüktif trombositopeninin (örn: ITP) ayrýmýnda en geçerli taný yöntemi kemik iliði incelemesidir. Ancak kemik iliði incelemesi oldukça invaziv bir yöntem olup ITP gibi hiperdestrüktif trombositopeninin tanýsýnda yapýlmasý bazý çalýþmalarda önerilmemektedir. Son yýllarda yapýlan bazý çalýþmalarda MPV, PCT ve PDW gibi platelet parametrelerin trombositopeninin ayýrýcý tanýsýnda kullanýlabileceði ileri sürülmüþtür. Bu çalýþmada amacýmýz, bu parametrelerin trombositopeninin ayýrýcý tanýsýndaki etkinliðini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya trombositopenisi olan 164 hasta dahil edildi. Hastalar tanýsýna göre hiperdestrüktif (75 ITP) ve hipodestrüktif(25 AA, 25 MDS, 24AML, 15 ALL) trombositopeni olarak iki gruba ayrýldý. Hastalarýn tanýsý güncel hematoloji, patoloji rehberleri ve kromozom analizleri kullanýldý. K3EDTA’lý tüplere alýnan kan örnekleri Beckman-Coulter otomatik cihazlarda çalýþýldý.

BULGULAR: Trombosit sayýsý açýsýndan iki grup arasýnda herhangi bir farklýlýk yoktu. Cinsiyet, yaþ ve PDW açýsýndan iki grup arasýnda herhangi bir farklýlýk izlenmedi. Bununla birlikte MPV, hiperdestrüktif grupta hipodestrüktif gruptakilere göre belirgin olarak daha yüksekti. Bunun aksine PCT deðeri hiperdestrüktif grupta hipodestrüktif gruba göre önemli ölçüde daha düþüktü.
TARTIÞMA ve SONUÇ: Bu çalýþmada; trombosit parametrelerinin kullanýmýnýn, ITP hastalarýnýn tanýsýný güçlendirebileceði, diðer klinik ve laboratuvar testleri ile birlikte faydalý olabileceði saptandý.