A Study to Evaluate Use of Platelet Indices in Hyperdestructive Thrombocytopenia: A Two-year Experience from Tertiary Care Rural Hospital

Abstract

Background: Thrombocytopenia is one of the most common causes of abnormal bleeding and is defined as platelet counts < 1.5 lakhs/cumm. Three processes can cause thrombocytopenia, namely: Deficient platelet production, accelerated platelet destruction, and abnormal pooling of the platelets within the body. Of these, accelerated platelet destruction is the most common cause for thrombocytopenia and has variety of etiologies. The usefulness of bone marrow analysis in assessing accelerated platelet destruction is still debated. Therefore, a new simple and non-invasive diagnostic approach for thrombocytopenia is needed. Aims and Objectives: The present study was done with an aim to evaluate the use of platelet indices, namely, mean platelet volume (MPV), Platelet Distribution Width (PDW), and Platelet Large Cell Ratio (P-LCR) in differentiating the various causes of hyperdestructive thrombocytopenia. Materials and Methods: This was a prospective study conducted over a period of 2 years and consisted of 206 cases of hyperdestructive thrombocytopenia. After recording relevant clinical details, platelet count along with platelet indices – MPV, PDW, and P-LCR was recorded. Based on the etiopathology identified, cases were categorized into three groups: Group I: Immunologic – cases of Immune thrombocytopenic purpura (ITP), Group II: Non-immune: Cases of sepsis and other non-immune causes of platelet destruction, and Group III: Viral and parasitic infections. Platelet indices were compared between the study groups and the control group which included 100 healthy individuals. Comparison was done among the three study groups as well. Results & Conclusions: Dengue accounted for the highest number of 131 (89.72%) cases in the study. MPV, PDW, and P-LCR were significantly higher (P < 0.0001) when compared to the healthy controls except P-LCR in Group II. A statistically significant increase in MPV was noted among ITP cases when compared to other causes of thrombocytopenia. There wa