ABSTRACT
Thirty in-patients in the Department of General Medicine of Assiut University Hospital with thrombocytopenia were studied before treatment, twenty patients with chronic idiopathic thrombocytopenic purpura and ten patients with chronic leukemia [nine had chronic myeloid leukemia and one with lymphocytic leukemia]. The study also included ten normal individuals served as controls. Careful history and clinical examination were carried out for every patient and normal individual complete blood picture, bleeding time, clot retraction, prothrombin time, kaolin cephalin clotting time, platelet volume study including mean platelet volume and platelet volume distribution and platelet factor-3 availability were done. Statistical analysis of the results showed that patients with chronic idiopathic thrombocytopenic purpura had significantly prolonged bleeding time and reduced clot retraction, but there was no significant difference in prothrombin and kaolin cephalin clotting times between patients and normal individuals. They also had significantly increased mean platelet volume which varied inversely in linear pattern with platelet count. This linear inverse relation in chronic idiopathic thrombocytopenic purpura was the same in the control group. There was significantly increased mean percentage of microplatelets [3-6 FL] and large platelets [13 FL]. Also, 60% of patients with chronic idiopathic thrombocytopenic purpura had diminished platelet factor-3 availability. This analysis showed that patients with chronic leukemia had significant prolongation in bleeding time and reduction in clot retraction. They also had significant prolongation in prothrombin time and platelet volume study. Patients with chronic myeloid leukemia revealed significant increase in the mean platelet volume and in the mean percentage of large platelets [13 FL]. There was also a linear inverse relation between the mean platelet volume and platelet count. Platelet factor-3 availability was diminished in 70% of patients