Original scientific paper

https://doi.org/10.20471/acc.2021.60.04.14

Clinical Relevance of Extended Platelet Indices in the Diagnosis of Immune Thrombocytopenia

Aisha Arshad ; Department of Postgraduate Studies and Research, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan; Department of Transplant Immunology and Applied Microbiology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
Samina Naz Mukry orcid.org/0000-0002-6876-0802 ; Department of Postgraduate Studies and Research, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan; Department of Transplant Immunology and Applied Microbiology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
Tahir Sultan Shamsi ; Department of Clinical Hematology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan

Abstract

Immune thrombocytopenia (ITP) is an autoimmune disorder. Besides platelet
count, immature platelet fraction (IPF) can be used as a tool to predict megakaryocytic activity in ITP
patients. The aim of the study was to evaluate the utility of extended platelet indices in ITP diagnosis
and their association with disease persistence and severity. This case-control study (1:1), conducted from
January 2015 to December 2017, included 111 ITP patients and 111 healthy controls. ITP patients
were grouped as newly diagnosed ITP, persistent ITP, chronic ITP, and refractory ITP patients. Peripheral
blood was collected and complete blood profile parameters were recorded using Sysmex XN 1000.
Significant (p≤0.05) difference between the groups of ITP patients and healthy control subjects was
determined by Fisher exact test, while Pearson correlation was used to evaluate platelet count correlation
with IPF using SPSS ver. 23. Low hemoglobin and platelet counts with high total leukocyte count
and IPF were detected in ITP patients as compared to healthy subjects (p≤0.001). Among all groups of
ITP patients, very low platelet count (6.9±6.02.x109/L) with highest mean IPF (27.1±19.2%) was observed
in newly diagnosed ITP group. Other platelet parameters including mean platelet volume
(MPV), plateletcrit, platelet large cell ratio (P-LCR) and platelet distribution width values were also
altered in patient groups. Pearson correlation revealed negative relationship between platelet count and
IPF in all patient groups. With the advent of new, sophisticated hematologic analyzers, the IPF and
other platelet parameters provide simple, reliable and easier tools for predicting platelet disorders such
as ITP, and to some extent the disease severity. Besides IPF, the MPV and P-LCR seemed to predict
disease severity, treatment responsiveness, and duration of the disease to some extent.

Keywords

Immune thrombocytopenia purpura; Chronic immune thrombocytopenia; Mean platelet volume; Immature platelet fraction

Hrčak ID:

275502

URI

https://hrcak.srce.hr/275502

Publication date:

1.12.2021.

Article data in other languages: croatian

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