ABSTRACT
Background: Thrombocytopenia (TCP) is low platelets count, which is either due to defective platelet production or due to increased platelet breakdown. The platelet number alone does not give a complete picture of platelet maturity and function, therefore, the platelet indices have been the subject of intensive study in recent years, but they have not been firmly established. Mean platelet volume (MPV) and platelet distribution width (PDW) are useful parameters in evaluating disorders of platelets. This study was undertaken to evaluate the effectiveness of PDW in diagnosing causes of thrombocytopenia. Methods: 510 cases of thrombocytopenia and 500 cases of Control group with normal platelet count were included in the study. TCP was defined as platelet counts below 1.5 lacs/cumm. Hematological analysis was done on Mindray BC-3000 plus automated hematology analyzer. All cases were reevaluated by peripheral smear examination. Only those cases were included in the study, which showed platelet count and platelet volume parameters with graph both in cases and in control group. Results: Hyper-destructive group constituted majority of the cases 352 (69%), while hypo-productive group and abnormal pooling constituted 30% and 1.42% cases respectively. The mean PDW was significantly higher in hyper-destructive group when compared with hypo-productive group, Abnormal pooling and control group. The difference was statistically significant. Conclusion: PDW provides plenty of clinical information about the causes and patho-mechanisms of thrombocytopenia and could be helpful to distinguish hyper-destructive thrombocytopenia from hypo-productive thrombocytopenia. More attention should be paid to PDW along with other platelet indices to differentiate between hyper-destructive TCP from hypo-productive and abnormal pooling TCP.
ABSTRACT
Background: Platelet volume parameters are significant especially in diagnosis of causes of thrombocytopenia. The platelet parameters are widely available as part of full blood count with no extra cost. Thrombocytopenia is of varying etiology based on which it is broadly divided into three major categories (1) as increased destruction, (2) decreased production and (3) splenic sequestration/abnormal pooling. The present study was undertaken to understand relation between cause of thrombocytopenia and Platelet Distribution Width as well as other platelet parameters. Materials and Methods: 500 cases of Thrombocytopenia (TCP) and 300 control cases having normal platelet count were selected. TCP was defined as platelet count <1.5lakh/ìl. Analysis was done by Sysmex KX 21 cell counter and every case was reassessed by Peripheral Smear (P.S.) examination and if necessary also by manual method. Only those cases that had sufficient clinico-hematological work -up and the causes of low platelet count had been reliably established were included in the study. Results: The study was conducted on 500 cases they were broadly categorized into three groups Group A with accelerated platelet Destruction Group B with Impaired production and Group C with abnormal pooling. Out of 500 cases 272 (54%) were male and 228(46%) were female. A slight male preponderance was seen in overall picture as well as in almost all age groups. The overall male to female ratio being 1.19 : 1. Mean platelet volume [MPV] was statistically significant with ‘p’ values