[Evaluation of platelet indices for differential diagnosis of thrombocytosis by ADVIA 120].
ABSTRACT For the diagnosis of essential thrombocythemia (ET), no single clinical or laboratory finding of diagnostic value is available and a differential diagnosis of other myeloproliferative neoplasms or reactive thrombocytosis (RT) is needed. Following recent developments in automated blood cell analyzers, various platelet indices can now be measured. In this study, we analyzed whether platelet counts and 6 platelet indices can be used for the differentiation of ET from RT in patients with a platelet count of 600x10(3)/microL or more.
The subjects studied were 31 patients with ET and 224 patients with RT. The platelet counts, mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), mean platelet mass (MPM), mean platelet component concentration (MPC) and large platelets (LPLT) were measured by ADVIA 120 (Bayer Diagnostics, USA). The mean values of each item were compared between the two patient groups and the sensitivity and specificity of each item in the diagnosis of ET were determined by ROC curve analysis.
In essential thrombocythemia, all parameters except MPC were significantly higher than in reactive thrombocytosis. For the diagnosis of ET, the sensitivity and specificity were: 74.2% and 84.4%, when the platelet count was > or = 820 x 10(3)/microL; 80.6% and 80.0%, when the plateletcrit was > or = 0.63%; and 64.5% and 99.1%, respectively, when LPLT was > or = 23 x 10(3)/microL.
The platelet counts and platelet indices are useful for the differential diagnosis of thrombocytosis. The plateletcrit and LPLT are particularly useful for the diagnosis of ET when the platelet count is markedly increased.
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ABSTRACT: Thrombocytopenia is caused by insufficient production and excessive destruction of platelets. Recent improvement of automated blood cell analyzers has allowed measurement of several platelet parameters, providing better understanding of the underlying mechanisms of thrombocytopenia. We investigated the significance of platelet parameters in thrombocytopenic patients. Thrombocytopenic patients (platelet <100 × 10/μl) who were newly diagnosed with acute myeloid leukemia and primary immune thrombocytopenia were enrolled, and platelet, mean platelet volume, platelet distribution width, platelet crit, mean platelet component, mean platelet mass, and large platelet count were measured, and the percentages of large platelets were calculated. The parameters were also measured in the reference population. The mean values of each parameter were as follows: platelet, 259 × 10/μl; mean platelet volume, 7.9 fl; platelet distribution width, 51.3%; platelet crit, 0.20%; mean platelet component, 26.0 g/dl; mean platelet mass, 1.9 pg; large platelet, 4.7 × 10/μl; large platelet percentage, 1.7%. In comparison with acute myeloid leukemia patients, patients with primary immune thrombocytopenia showed significantly higher mean platelet volume, platelet distribution width, mean platelet component, mean platelet mass, large platelet, and large platelet % (P < 0.05). Because of increased destruction of platelets, primary immune thrombocytopenia patients have increased mean platelet volume, platelet distribution width, mean platelet component, mean platelet mass, large platelet, and large platelet percentage compared with acute myeloid leukemia patients who have ineffective platelet production. Parameters measured by automated analyzer provide better understanding of thrombopoiesis in the bone marrow and the status of the peripheral blood in the clinical field.Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 04/2014; 25(3):221-225. DOI:10.1097/MBC.0000000000000027 · 1.38 Impact Factor
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ABSTRACT: The aim of this study was to determine the association of mean platelet volume (MPV) with the development of stroke or coronary artery disease (CAD) in diabetes mellitus (DM). MPV was analyzed in 200 Korean patients with DM. The primary endpoint was composite of ischemic stroke/CAD events. The mean MPV was 7.6 ± 0.8 fl. There were 14 ischemic stroke events and 8 CAD events during a mean of 28.4 months of follow-up. The Kaplan-Meier analysis revealed that the higher tertile MPV group (≥7.9 fl) had a significantly higher stroke/CAD rate compared to the lower tertile MPV group (≤7.3 fl) (29.9% vs. 2.8%, log-rank: p < 0.001). Higher MPV was an independent predictor of stroke/CAD risk after adjusting for 10-year risk ≥10%, hypertension, dyslipidemia, and previous stroke or transient ischemic attack history (hazard ratio: 11.92, 95% confidence interval 2.68-52.92, p = 0.001) in the Cox proportional hazard analysis. When the MPV cut-off level was set to 7.95 fl using the receiver operating characteristic curve, the sensitivity was 91% and the specificity was 80% for differentiating between the group with stroke/CAD and the group without stroke/CAD. This value was more useful in patients with hypertension. The results of this study show that MPV is a predictive marker for stroke/CAD; its predictive power for stroke/CAD is independent of age, gender, hypertension, and hemoglobin A1C.Platelets 08/2012; DOI:10.3109/09537104.2012.710858 · 2.63 Impact Factor
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ABSTRACT: Changes of platelet count (PLT) and platelet parameters have been reported in iron deficiency anemia (IDA). However, the relationship between iron metabolism and thrombopoiesis is not yet fully known. We studied the relationship between iron and platelet parameters in women with IDA and thrombocytosis. Forty-one adult women with IDA and thrombocytosis were enrolled. The relationship between iron parameters (such as serum iron, serum ferritin, total iron-binding capacity (TIBC)C, and transferrin saturation (Tfsat)), and platelet parameters (PLT, platelet crit (PCT), mean platelet volume (MPV), mean platelet component (MPC), mean platelet mass, platelet distribution width, and large platelet (LPLT)), which measured with CBC on ADVIA, were investigated. In addition, the difference in platelet and iron parameters between severe IDA (Hb < 7 g/dl) and non-severe IDA were compared. PLT inversely correlated with serum iron and Tfsat (p < 0.05). Serum iron and TIBC revealed no significant relationships with any platelet parameters. PLT, PCT, and MPV inversely correlated with mean corpuscular hemoglobin concentration (MCHC) but MPC exhibited linear correlation with Hb, hematocrit, and MCHC (p < 0.05). PCT had linear correlation with PLT and MPV (p < 0.001), whereas PCT, MPV, and LPLT (p < 0.001 for two formers, p < 0.05) inversely correlated with MPC. In this study, the important iron parameters affecting PLT were serum iron and Tfsat. In addition, patients with more severe and hypochromic anemia had higher PLT, PCT, and MPV.Platelets 06/2012; DOI:10.3109/09537104.2012.699641 · 2.63 Impact Factor