Platelet indices and angiogenesis markers in hypertensive disorders of pregnancy.

INTRODUCTION: Activated platelets exert a key role in the pathogenesis of preeclampsia (PE). There is evidence of distinctive patterns of platelet indices in PE in comparison to healthy pregnancies, therefore these indices can be potential tools for PE detection, risk stratification, and management. Considering the vascular aspects of its pathophysiology, PE is characterized by the increased levels of soluble FMS-like tyrosine kinase-1 (sFlt-1) an antiangiogenic factor, and reduced placental growth factor (PlGF), a proangiogenic factor. This study aimed to assess the platelet indices in hypertensive disorders of pregnancy (HDP) and its correlation with angiogenesis-related biomarkers. METHODS: The groups for the study were: control (n = 114); gestational hypertension; (n = 112), and PE (n = 42). The platelet indices included were platelet counts (PLT-I and PLT-F), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet large cell ratio (P-LCR), and immature platelet fraction (IPF# and IPF%). Serum levels of sFlt-1 and PlGF were assessed. RESULTS: PLT-I, PLT-F, and PCT% were lower in PE, while MPV, PDW, P-LCR, IPF%, and IPF# were increased. The parameter MPV presented the best performance for the discrimination of PE. There was a moderate positive correlation between sFlt-1 levels and MPV, PDW, and P-LCR. CONCLUSION: Platelet indices can be potentially applied as additional tools for the diagnosis and management of HDP. Activated platelets may act as an extra source of sFlt-1 in PE.

Diagnosis of transmissible venereal tumors in bitches - platelet indices are a remarkable marker?

Background: Hematological analyses are seen as more preferred laboratory analyses in canine transmissible venereal tumor studies. There is no information about the availability of platelets and their indices in routine practice in canine transmissible venereal tumor cases. Taking this as a starting point, this study analyzed the usefulness of platelet indices in dogs with transmissible venereal tumor in clinical laboratory diagnosis as well as examined the relationship between white blood cells, red blood cells, platelets (PLT), main platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and the ratio of main platelet volume to platelets (MPV/PLT). Materials, Methods & Results: In the study, a total of 42 bitches of various breeds were used. Nineteen healthy bitches were used as a control group, and the others 23 with cTVT as a study group. Metastasis was not observed in any of the bitches involved in the study. History, clinical findings, and cytological examinations were evaluated for the diagnosis of cTVT. In animals with hemorrhagic discharge and neoplastic lesions, a vaginal cytological examination was performed. Typical TVT cells with large nuclei and intracytoplasmic vacuoles were observed in the vaginal cytological examinations, and the diagnosis of TVT was made. Healthy bitches (19) and those with TVT (23) were 39.16 5.37 months and 47.61 5.14 months old, respectively. From all animals, 2 mL blood samples were collected from V. cephalica to evaluate PIs in the complete blood count (CBC). Collected blood samples were analyzed using an automated hematology analyzer. As a result of the analysis, WBC, RBC, HGB, HCT, MCV, MCHC, RDW, PLT, MPV, PDW, PCT, and MPV/PLT data were obtained. Mild leukocytosis, an increase in PLT, and a decrease in MCV and MPV/PLT were determined in the study group compared to the control group. Cut-off values in CBC of bitches with TVT were determined as WBC: 13.35 (sensitivity: 78%; specificity: 90%); MCV: 67 (sensitivity: 57%; specificity: 95%); PLT: 315.50 (sensitivity: 65%; specificity: 74%); and MPV/PLT: 0.028 (sensitivity: 78%; specificity: 58%). In CBC analyses, a strong negative correlation between PLT and MPV/PLT was detected in both groups. Discussion: Canine transmissible venereal tumors are common in both stray and pet dogs. It is naturally transferred from animal to animal during mating by live tumor cells. This tumor can commonly affect the external genitalia and internal organs in some cases. It generally has the look of cauliflower, and its surface is ulcerated, inflammatory, hemorrhagic, and infectious. More preferred laboratory analyses are complete blood count and blood chemistry analysis in cTVT for to evaluate the success of treatments. Platelet indices have been investigated in many diseases such as endotoxemia, chronic enteropathy, mammary tumor, parvoviral enteritis, septic peritonitis, lymphoma, pyometra, visceral leishmaniasis, and babesiosis in dogs. There is no information available for either diagnostic or prognostic use of the PIs in canine TVT cases. Ultimately, in light of the presented study's results, platelet indices, especially PLT and the MPV/PLT ratio, seem to be notable laboratory markers in terms of easy accessibility and low-cost assessment techniques in canine transmissible venereal tumor cases. New data, however, should be established by a thorough follow-up study using a larger sample size and addressing its usefulness as a diagnostic or prognostic marker in canine transmissible venereal tumors.

COVID-19 in Pregnancy: Implication on Platelets and Blood Indices / COVID-19 na gravidez: implicações nas plaquetas e índices sanguíneos

Abstract Objective To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women. Methods A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation. Results Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87±66.92 fL for the case group versus 9.84±1.2 fL for the control group; PDW: 14.82±3.18 fL for the case group versus 13.3±2.16 fL for the controls). The criterionvalue of the receiver operating characteristic (ROC) curve forPDWat a cutoffpoint of>11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of>10.17 fL showed a good diagnostic marker. Conclusion The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.

Resumo Objetivo Descrever as alterações hematológicas, em particular os índices plaquetários em gestantes com doença coronavírus 2019 (COVID-19) em comparação com gestantes saudáveis. Métodos Estudo caso-controle retrospectivo realizado no Hospital Universitário Al Yarmouk, em Bagdá, Iraque envolvendo 100 gestantes, 50 com DNA viral positivo para COVID-19 (grupo caso) e 50 com resultados negativos (grupo controle); ambos os grupos foram submetidos a uma avaliação hematológica completa. Resultados Entre as principais variáveis hematológicas analisadas, os índices plaquetários, nomeadamente o volume plaquetário médio (VPM) e a largura de distribuição plaquetária (PDW), apresentaram diferenças estatisticamente significativas (VPM: 10,87±66,92 fL para o grupo caso versus 9,84±1.2 fL para o o grupo controle; PDW: 14,82±3,18 fL para o grupo caso versus 13,3±2,16 fL para os controles). O valor de critério da curva de característica de operação do receptor (ROC) para PDW em um ponto de corte de> 11,8 fL mostrou um marcador diagnóstico fraco, enquanto o do VPM emumvalor de corte de> 10,17 fL mostrou um bom marcador de diagnóstico. Conclusão OMPVe PDWsão significativamente afetados por esta infecção viral, mesmo em casos confirmados assintomáticos, e recomendamos que ambos os parâmetros sejam incluídos no painel de diagnóstico desta infecção.

Evaluation of platelet indices and complete blood count in canine mammary tumors

Malignant mammary tumors in humans and bitches cause hematological disorders such as anemia, erythrocytosis, thrombocytosis, hyperproteinemia, and leucopenia. Novel studies have been conducted on the predictive and prognostic values of platelet (PLT) indices in human breast cancer (HBC). However, there is little information about the alterations in hematological parameters in canine mammary tumors (CMTs). The aims of this study were to evaluate the platelet indices and complete blood count (CBC) parameters in bitches with and without mammary tumor and to assess the above mentioned parameters with regard to histological tumor types and grades. A total of 71 bitches were enrolled in this study. The bitches in the study group were divided into 2 groups which consisted of malignant epithelial mammary tumors (group EMT; n = 43) and malignant mixed mammary tumors (group MMT; n = 12). Control group (group C) consisted of clinically and gynaecologically healthy 16 bitches. Blood samples were obtained to perform the CBC and PLT indices analysis. Histopathological examinations were carried out under a light microscope. Histological tumor types and malignancy grades were classified. The bitches with mammary tumor showed significantly increased PLT values and decreased hematocrit (HCT), hemoglobin (HGB) and mean corpuscular hemoglobin (MCH) values versus the healthy ones, regardless of the tumor type. However, in comparisons with the group C, mean platelet volume (MPV) and mean corpuscular hemoglobin concentration (MCHC) values were different only in the group MMT, while plateletcrit (PCT) and mean corpuscular volume (MCV) values were different only in the group EMT. Also white blood cell (WBC), PLT and PCT values were higher than the referenced laboratory ranges in grade 3 tumors. In the presented study, MPV was considerably correlated with PLT, platelet distribution width (PDW) and PCT. Also, PCT and PLT had high sensitivity and specificity to distinct EMT and MMT from the healthy bitches. Microcytic and hypochromic anemia occurs due to the decrease in the amount of HGB. Levels of MCV, MCH, and MCHC in the HBC group were reported to be significantly lower than in humans without breast cancer. Although anemia did not occur in EMT and MMT groups, obtained significances in the HCT, HGB, MCV, MCH, and MCHC levels between the bitches with and without mammary tumor were in line with the previous reports. In this study, WBC levels in grade 3 tumors were significantly higher than grade1 tumors (P < 0.05). Whereas levels of WBC in grade 1 and grade 2 tumors were in referenced laboratory ranges, it was higher in grade 3. Increased level of WBC in grade 3 was supposed to be due to the rise in malignancy as previously reported. Thrombocytosis was detected in 48.83% and 41.66% of the bitches in EMT and MMT groups, respectively. The higher percentage of CMTs with thrombocytosis in this study might be due to the difference in referenced upper limit of PLT in previous studies. The elapsed time between tumor formation and clinical presentation could be another influencing factor. Although PLT and PCT values were not significant according to the histological grading in this study, both parameters were found to be higher in grade 3 than the normal reference values. Further studies conducted with higher populations may lead the differences in these parameters to significance. With the support of further studies, alterations in the above mentioned parameters in bitches may contribute in the diagnosis process, management of treatment and may constitute an easy way to have an idea about the prognosis of mammary tumors.(AU)

Valoración de índices plaquetarios en las trombocitopenias / Valuation of platelet índices in thrombocytopenia / Avaliagáo de índices plaquetários nas trombocitopenias

El objetivo de este trabajo fue determinar la utilidad clínica de los índices plaquetarios en la caracterización etiológica de las trombocitopenias. Se trata de un estudio descriptivo, retrospectivo y transversal. En pacientes controles se establecieron valores de referencia para número de plaquetas e índices plaquetarios, y éstos se evaluaron en pacientes donde coexistía trombocitopenia con algún desorden oncohematológico (linfoma no Hodgkin, linfoma Hodgkin, leucemia aguda, leucemia crónica, síndrome mielodisplásico, púrpura trombocitopénica inmune). La evaluación de laboratorio fue realizada al momento del diagnóstico, aún libre de tratamiento. En los casos de Púrpura Inmune (disminución de Volumen Plaquetario - Plaquetocrito, y aumento de Amplitud Plaquetaria); Leucemia Mieloide Crónica (aumento de la Amplitud Plaquetaria) y Linfoma no Hodgkin o Síndrome Mielodisplásico (disminución del Plaquetocrito), los índices plaquetarios podrían ser usados como herramienta diagnóstica orientadora. En cambio, no podrían contribuir al momento de diferenciar entre leucemias agudas, dado que no presentan diferencias significativas. Frente a un diagnóstico presuntivo de síndrome mielodiasplásico o leucemia mieloide aguda, el valor de Volumen Plaquetario Medio (VPM) podría contribuir como herramienta orientadora al diagnóstico, ya que sería más bajo en la leucemia aguda. El análisis de los resultados sugiere que en la práctica clínica los índices plaquetarios podrían contribuir de un modo significativo a la confirmación del diagnóstico.(AU)

The aim of this study was to determine the clinical utility of platelet indices in the etiological characterization of thrombocytopenia. It was a descriptive, retrospective and cross-sectional study. In control patients, reference values (platelet count and platelet indices) were established and they were used to assess platelet indices in patients where thrombocytopenia coexisted with some oncohematologic disorders (non-Hodgkin Lymphoma, Hodgkin Lymphoma, acute leukemia, chronic leukemia, myelodysplastic syndrome, immune thrombocytopenic purpura). Laboratory evaluation was performed at still treatment-free diagnosis. In the cases of Immune Purpura, (decreased platelet volume- plateletcrit, and increased platelet distribution width) Chronic Myeloid Leukemia (increased platelet distribution width) and non-Hodgkin lymphoma or myelodysplastic syndrome (decreased plateletcrit), platelet indices could be used as a "guiding diagnostic tool". However, they could not contribute to the differenciation between acute leukemias since they do not present any significant differences. In view of a presumptive diagnosis of mielodysplastic syndrome or acute myeloid leukemia, mean platelet value (MPV) could contribute to the diagnosis, since it would be lower in acute leukemia. The analysis of the results suggests that in clinical practice, platelet indices may contribute significantly to the confirmation of the diagnosis.(AU)

O objetivo deste trabalho foi determinar a utilidade clínica dos índices plaquetários na caracterizagáo etiológica das trombocitopenias. Trata-se de um estudo descritivo, retrospectivo e transversal. Em pacientes controle foram estabelecidos valores de referencia para número de plaquetas e índices plaquetários, e eles foram avaliados em pacientes onde coexistia trombocitopenia com alguma desordem onco-hematológica (linfoma náo Hodgkin, linfoma Hodgkin, leucemia aguda, leucemia crónica, síndrome mielodisplásica, púrpura trombocitopenia imune). A avaliagáo de laboratório foi realizada no momento do diagnóstico, ainda livre de tratamento. Nos casos de Púrpura Imune (diminuigáo de Volume Plaquetario - Plaquetócrito, e aumento de Amplitude Plaquetária); Leucemia Mieloide Crónica (aumento da Amplitude Plaquetária) e Linfoma náo Hodgkin ou Síndrome Mielodisplásica (diminuigáo do Plaquetócrito), os índices plaquetários poderiam ser usados como ferramenta diagnóstica orientadora. Entretanto, náo poderiam contribuir no momento de diferenciar entre leucemias agudas, visto que náo apresentam diferengas significativas. Diante de um diagnóstico presuntivo de síndrome mielodiasplásica ou leucemia mieloide aguda, o valor de Volume Plaquetário Médio (VPM) poderia contribuir como ferramenta orientadora para o diagnóstico, devido a que seria mais baixo na leucemia aguda. A análise dos resultados sugere que na prática clínica os índices plaquetários poderiam contribuir de um modo significativo para a confirmagáo do diagnóstico.(AU)

Valoración de índices plaquetarios en las trombocitopenias / Valuation of platelet índices in thrombocytopenia / Avaliagáo de índices plaquetários nas trombocitopenias

El objetivo de este trabajo fue determinar la utilidad clínica de los índices plaquetarios en la caracterización etiológica de las trombocitopenias. Se trata de un estudio descriptivo, retrospectivo y transversal. En pacientes controles se establecieron valores de referencia para número de plaquetas e índices plaquetarios, y éstos se evaluaron en pacientes donde coexistía trombocitopenia con algún desorden oncohematológico (linfoma no Hodgkin, linfoma Hodgkin, leucemia aguda, leucemia crónica, síndrome mielodisplásico, púrpura trombocitopénica inmune). La evaluación de laboratorio fue realizada al momento del diagnóstico, aún libre de tratamiento. En los casos de Púrpura Inmune (disminución de Volumen Plaquetario - Plaquetocrito, y aumento de Amplitud Plaquetaria); Leucemia Mieloide Crónica (aumento de la Amplitud Plaquetaria) y Linfoma no Hodgkin o Síndrome Mielodisplásico (disminución del Plaquetocrito), los índices plaquetarios podrían ser usados como herramienta diagnóstica orientadora. En cambio, no podrían contribuir al momento de diferenciar entre leucemias agudas, dado que no presentan diferencias significativas. Frente a un diagnóstico presuntivo de síndrome mielodiasplásico o leucemia mieloide aguda, el valor de Volumen Plaquetario Medio (VPM) podría contribuir como herramienta orientadora al diagnóstico, ya que sería más bajo en la leucemia aguda. El análisis de los resultados sugiere que en la práctica clínica los índices plaquetarios podrían contribuir de un modo significativo a la confirmación del diagnóstico.(AU)

The aim of this study was to determine the clinical utility of platelet indices in the etiological characterization of thrombocytopenia. It was a descriptive, retrospective and cross-sectional study. In control patients, reference values (platelet count and platelet indices) were established and they were used to assess platelet indices in patients where thrombocytopenia coexisted with some oncohematologic disorders (non-Hodgkin Lymphoma, Hodgkin Lymphoma, acute leukemia, chronic leukemia, myelodysplastic syndrome, immune thrombocytopenic purpura). Laboratory evaluation was performed at still treatment-free diagnosis. In the cases of Immune Purpura, (decreased platelet volume- plateletcrit, and increased platelet distribution width) Chronic Myeloid Leukemia (increased platelet distribution width) and non-Hodgkin lymphoma or myelodysplastic syndrome (decreased plateletcrit), platelet indices could be used as a "guiding diagnostic tool". However, they could not contribute to the differenciation between acute leukemias since they do not present any significant differences. In view of a presumptive diagnosis of mielodysplastic syndrome or acute myeloid leukemia, mean platelet value (MPV) could contribute to the diagnosis, since it would be lower in acute leukemia. The analysis of the results suggests that in clinical practice, platelet indices may contribute significantly to the confirmation of the diagnosis.(AU)

O objetivo deste trabalho foi determinar a utilidade clínica dos índices plaquetários na caracterizagáo etiológica das trombocitopenias. Trata-se de um estudo descritivo, retrospectivo e transversal. Em pacientes controle foram estabelecidos valores de referencia para número de plaquetas e índices plaquetários, e eles foram avaliados em pacientes onde coexistia trombocitopenia com alguma desordem onco-hematológica (linfoma náo Hodgkin, linfoma Hodgkin, leucemia aguda, leucemia crónica, síndrome mielodisplásica, púrpura trombocitopenia imune). A avaliagáo de laboratório foi realizada no momento do diagnóstico, ainda livre de tratamento. Nos casos de Púrpura Imune (diminuigáo de Volume Plaquetario - Plaquetócrito, e aumento de Amplitude Plaquetária); Leucemia Mieloide Crónica (aumento da Amplitude Plaquetária) e Linfoma náo Hodgkin ou Síndrome Mielodisplásica (diminuigáo do Plaquetócrito), os índices plaquetários poderiam ser usados como ferramenta diagnóstica orientadora. Entretanto, náo poderiam contribuir no momento de diferenciar entre leucemias agudas, visto que náo apresentam diferengas significativas. Diante de um diagnóstico presuntivo de síndrome mielodiasplásica ou leucemia mieloide aguda, o valor de Volume Plaquetário Médio (VPM) poderia contribuir como ferramenta orientadora para o diagnóstico, devido a que seria mais baixo na leucemia aguda. A análise dos resultados sugere que na prática clínica os índices plaquetários poderiam contribuir de um modo significativo para a confirmagáo do diagnóstico.(AU)

Valoración de índices plaquetarios en las trombocitopenias / Valuation of platelet índices in thrombocytopenia / Avaliagáo de índices plaquetários nas trombocitopenias

El objetivo de este trabajo fue determinar la utilidad clínica de los índices plaquetarios en la caracterización etiológica de las trombocitopenias. Se trata de un estudio descriptivo, retrospectivo y transversal. En pacientes controles se establecieron valores de referencia para número de plaquetas e índices plaquetarios, y éstos se evaluaron en pacientes donde coexistía trombocitopenia con algún desorden oncohematológico (linfoma no Hodgkin, linfoma Hodgkin, leucemia aguda, leucemia crónica, síndrome mielodisplásico, púrpura trombocitopénica inmune). La evaluación de laboratorio fue realizada al momento del diagnóstico, aún libre de tratamiento. En los casos de Púrpura Inmune (disminución de Volumen Plaquetario - Plaquetocrito, y aumento de Amplitud Plaquetaria); Leucemia Mieloide Crónica (aumento de la Amplitud Plaquetaria) y Linfoma no Hodgkin o Síndrome Mielodisplásico (disminución del Plaquetocrito), los índices plaquetarios podrían ser usados como herramienta diagnóstica orientadora. En cambio, no podrían contribuir al momento de diferenciar entre leucemias agudas, dado que no presentan diferencias significativas. Frente a un diagnóstico presuntivo de síndrome mielodiasplásico o leucemia mieloide aguda, el valor de Volumen Plaquetario Medio (VPM) podría contribuir como herramienta orientadora al diagnóstico, ya que sería más bajo en la leucemia aguda. El análisis de los resultados sugiere que en la práctica clínica los índices plaquetarios podrían contribuir de un modo significativo a la confirmación del diagnóstico.

The aim of this study was to determine the clinical utility of platelet indices in the etiological characterization of thrombocytopenia. It was a descriptive, retrospective and cross-sectional study. In control patients, reference values (platelet count and platelet indices) were established and they were used to assess platelet indices in patients where thrombocytopenia coexisted with some oncohematologic disorders (non-Hodgkin Lymphoma, Hodgkin Lymphoma, acute leukemia, chronic leukemia, myelodysplastic syndrome, immune thrombocytopenic purpura). Laboratory evaluation was performed at still treatment-free diagnosis. In the cases of Immune Purpura, (decreased platelet volume- plateletcrit, and increased platelet distribution width) Chronic Myeloid Leukemia (increased platelet distribution width) and non-Hodgkin lymphoma or myelodysplastic syndrome (decreased plateletcrit), platelet indices could be used as a "guiding diagnostic tool". However, they could not contribute to the differenciation between acute leukemias since they do not present any significant differences. In view of a presumptive diagnosis of mielodysplastic syndrome or acute myeloid leukemia, mean platelet value (MPV) could contribute to the diagnosis, since it would be lower in acute leukemia. The analysis of the results suggests that in clinical practice, platelet indices may contribute significantly to the confirmation of the diagnosis.

O objetivo deste trabalho foi determinar a utilidade clínica dos índices plaquetários na caracterizagáo etiológica das trombocitopenias. Trata-se de um estudo descritivo, retrospectivo e transversal. Em pacientes controle foram estabelecidos valores de referencia para número de plaquetas e índices plaquetários, e eles foram avaliados em pacientes onde coexistia trombocitopenia com alguma desordem onco-hematológica (linfoma náo Hodgkin, linfoma Hodgkin, leucemia aguda, leucemia crónica, síndrome mielodisplásica, púrpura trombocitopenia imune). A avaliagáo de laboratório foi realizada no momento do diagnóstico, ainda livre de tratamento. Nos casos de Púrpura Imune (diminuigáo de Volume Plaquetario - Plaquetócrito, e aumento de Amplitude Plaquetária); Leucemia Mieloide Crónica (aumento da Amplitude Plaquetária) e Linfoma náo Hodgkin ou Síndrome Mielodisplásica (diminuigáo do Plaquetócrito), os índices plaquetários poderiam ser usados como ferramenta diagnóstica orientadora. Entretanto, náo poderiam contribuir no momento de diferenciar entre leucemias agudas, visto que náo apresentam diferengas significativas. Diante de um diagnóstico presuntivo de síndrome mielodiasplásica ou leucemia mieloide aguda, o valor de Volume Plaquetário Médio (VPM) poderia contribuir como ferramenta orientadora para o diagnóstico, devido a que seria mais baixo na leucemia aguda. A análise dos resultados sugere que na prática clínica os índices plaquetários poderiam contribuir de um modo significativo para a confirmagáo do diagnóstico.