Evaluation of Platelet Indices in Distinguishing Types of Thrombocytopenia

Platelets originate from cytoplasmic fragmentation of mature megakaryocytes, these are essential for maintaining hemostasis balance, regulating inflammatory response, and immune response and wound healing. A platelet count of less than 150 x 109 /L is an indicative of thrombocytopenia , which can result of either impaired platelet production (hypo proliferative ) or increased platelet destruction (hyper destructive). Bone marrow examination is the definitive method in distinguishing between hypo proliferative and hyper destructive thrombocytopenia, but its invasive nature and associated bleeding makes it less desirable option for patients .In contrast ,evaluating platelet indices is less invasive, simpler and effective method for distinguishing types of thrombocytopenia. The platelets indexes that can be used are Plateletcrit (PCT), Mean Platelet Volume (MPV) ,Platelet Large Cell Ratio(P-LCR) and Platelet Distribution Width (PDW). This study seeks to evaluate values of platelet indices in differentiating between various types of thrombocytopenia, thereby help in diagnosis and management. To determine the role of platelet indices in discriminating hypo proliferative and hyper destructive type of thrombocytopenia and to determine platelet indices in various causes in thrombocytopenia disorders. A prospective study of 62 patients with thrombocytopenia was done a period of six months in department of pathology, to determine type of thrombocytopenia based on platelet indices. All 62 cases data were entered into a Microsoft Excel spreadsheet, then analyzed using SPSS Statistics version 22. Quantitative data were summarized as mean ± standard deviation or median with range, depending on distribution. Qualitative variables were assessed using the chi-square test, with statistical significance set at p < 0.05.31cases were classified as hyperdestructive thrombocytopenia and 31 cases as hypoproliferative thrombocytopenia. 35 males and 27 females. Among those with hyperdestructive thrombocytopenia, 61.3% were males and 38.7% were females. On comparing platelet parameters between the two groups, the mean platelet count in the hyperdestructive group was 90354.839±35465.052/cumm, whereas in the hypoproliferative group it was slightly lower 95451.613±35647.196 /cumm. This difference was not statistically significant (p = 0.4682). Statistically significant difference was observed in the platelet large cell ratio (P-LCR), which was higher in hyper destructive thrombocytopenia (32.616±9.008)compared to hypo proliferative thrombocytopenia (28.139±7.832), with a p-value of 0.03.The mean platelet volume (MPV) was significantly higher in hyperdestructive thrombocytopenia at 11.17 fL compared to 10.48 fL in hypo proliferative thrombocytopenia (p=0.009). MPV and P-LCR are greatly elevated in hyper destructive thrombocytopenia and are excellent markers in differentiating the types of thrombocytopenia. Their application in routine examination can be useful in early diagnosis, but they need to be confirmed through large-scale studies.