ASSESSING THE CLINICAL UTILITY OF PLATELET MORPHOMETRIC PARAMETERS IN IDENTIFYING UNDERLYING MECHANISMS OF THROMBOCYTOPENIA

Abstract

Background: Proper management of thrombocytopenia requires a clear understanding of whether the root cause is diminished platelet synthesis or excessive breakdown. We investigated the significance of platelet indices as a non-invasive alternative to conventional diagnostics like bone marrow examination. This research aimed to assess whether Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), and Platelet-Large Cell Ratio (P-LCR) can effectively differentiate between hypoproductive and hyperdestructive types of thrombocytopenia.

Methods: This study, carried out over 18 months at a tertiary care facility, prospectively and comparatively analyzed 300 patients presenting with thrombocytopenia (platelet count <150 × 10⁹/L). Based on clinical, laboratory, and bone marrow findings, cases were divided into two group- hyperdestructive (n=250) and hypoproductive (n=50). An automated haematology analyzer was used to determine the platelet indices for each patient. Smear reviews were performed to rule out pseudothrombocytopenia, and cases affected by transfusion or pre-analytical delays were excluded. Data were analyzed using comparative statistics and ROC curve evaluation.

Results: Patients in the hyperdestructive group exhibited significantly higher values for MPV (11.1 ± 1.4 fL), PDW (17.8 ± 2.3%), and P-LCR (36.4 ± 5.6%) than those in the hypoproductive group (MPV 8.6 ± 1.2 fL, PDW 14.2 ± 1.9%, P-LCR 21.5 ± 4.3%), with all parameters showing strong statistical significance (p value < 0.001). Among the parameters analyzed, MPV demonstrated the greatest AUC in the ROC curve, suggesting it possesses the strongest diagnostic performance.

Conclusion: Platelet indices, particularly MPV, appear to be useful adjuncts in distinguishing between hypoproductive and hyperdestructive thrombocytopenia. When used alongside clinical and laboratory findings, these non-invasive markers may reduce dependence on bone marrow studies in selected cases.