Background: Bone marrow examination may be required to discriminate causes of thrombocytopenia as\nhypoproductive or hyperdestructive. However, this procedure is invasive and time consuming. This study\nassessed the diagnostic value of Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and Platelet\nLarge Cell-Ratio (P-LCR) in discriminating causes of thrombocytopenia as hypoproductive or hyperdestructive\n(Immune thrombocytopenia purpura).\nMethod: A prospective cross-sectional study was conducted on 83 thrombocytopenic patients (Plt < 150 Ã?â?? 109/L).\nFrom these, 50 patients had hypoproductive and the rest 33 Immune Thrombocytopenia Purpura (ITP). Age and sex\nmatched 42 healthy controls were included as a comparative group. Hematological analysis was carried out using\nSysmex XT 2000i 5 part diff analyzer. SPSS Version16 was used for data analysis. A two by two table and receiver\noperating characteristic (ROC) curve was used to calculate sensitivity, specificity, positive and negative predictive values,\nfor a given platelet indices (MPV, PDW and P-LCR). Student t test and Mann Whitney U test were used to compare\nmeans and medians, respectively. Correlation test was used to determine associations between continuous variables.\nResults: All Platelet indices were significantly higher in ITP patients (n = 33) than in hypoproductive thrombocytopenic\npatients (n = 50) (p < 0.0001). In particular MPV and P-LCR have larger area under ROC curve (0.876 and 0.816,\nrespectively), indicating a better predictive capacity, sensitivity and specificity in discriminating the two causes of\nthrombocytopenia. The indices were still significantly higher in ITP patients compared to 42 healthy controls (p < 0.0001).\nA significant negative correlation was observed between platelet count and platelet indices in ITP patients, (p < 0.001).\nConclusion: MPV, PDW and P-LCR help in predicting thrombocytopenic patients as having ITP or hypoproductive\nthrombocytopenia. If these indices are used in line with other laboratory and clinical information, they may help\nin delaying/ avoiding unnecessary bone marrow aspiration in ITP patients or supplement a request for bone morrow\naspiration or biopsy in hypoproductive thrombocytopenic patients.
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