Place of study: Department of Haematology, BSMMU The sensitivity and specificity of platelet indices to enable the diagnosis of ITP were also evaluated. So I wish to investigate the significances of these platelet indices in the diagnosis of thrombocytopenia by comparing the level of hypo-productive and hyper-destructive thrombocytopenia. If these indices are really informative regarding platelet kinetics, they might become very useful laboratory measures for thrombocytopenia. Among these parameters, platelet indices, such as mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), provide some important information 6–8 but are not accepted for routine clinical use. 5 Recent advances in automated blood cell analyzers had made it possible to measure various blood cell parameters automatically. 4 In fact, the necessity for both bone marrow aspiration and PAIgG in ITP is not accepted in the recent guideline. 3 Platelet-associated immunoglobulin G (PAIgG) is often elevated in ITP, but it is not specific to ITP and an increased PAIgG level is often found in many other diseases. There is no diagnostic test to absolutely say a patient has ITP. The diagnosis of ITP remains on exclusion. But its incidence is 58-66 new cases per million populations per year (5.8-6.00) in the US 2with similar incidence in the UK. 1 In Bangladesh we have no data regarding the incidence of adult chronic immune thrombocytopenia. Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by persistent thrombocytopenia (peripheral blood platelet count <150×10 9/l) due to autoantibody binding to platelet antigen(s) causing their premature destruction by the reticuloendothelial system and particularly in the spleen. Keywords: mean platelet volume, platelet distribution width, platelet large cell ratio, immune thrombocytopenic purpura Abbreviations Platelet indices, if reported, provide a lot of clinical information about the underlying conditions of thrombocytopenia. These indices could help to distinguish hyper-destructive thrombocytopenia and hypo-productive thrombocytopenia very easily and it is also cost effective. P-LCR cut of value >40% sensitivity was 100% and Specificity was 63.0%. PDW cut of value >15fl sensitivity was 100% and Specificity was 83.0%. PDW cut of value >14fl sensitivity was 86.67% and Specificity was 93.3%. MPV cut of value >11fl sensitivity was 73.33% and Specificity was 80.0%, MPV cut of value >12fl sensitivity was 53.3% and Specificity was 96.7%, MPV cut of value >13fl sensitivity was 26.7% and Specificity was 100%. Sensitivity and specificity of platelet indices to make a diagnosis of ITP was calculated under various cut-off ranges. In AA mean platelet large cell ratio was 21.07(±5.51)% and in ITP mean platelet large cell ratio was 36.68(☗.91)% and that was statistically significant. In AA mean platelet distribution width was 11.75(☒.13)fl and in ITP mean platelet distribution width was 18.07(☒.52)fl. In AA mean platelet volume was 9.75(☑.15)fl and in ITP mean platelet volume was 12.01(☑.23)fl. Mean platelet count was 38.73(☑5.99)x109/L and 30.46(☑4.17)x109/L in AA and ITP respectively and that was not statistically significant. Mean age of the study population of aplastic anaemia (AA) was 36.66(☑7.04)years and immune thrombocytopenic purpura (ITP) was 29.70(☑3.99)years. Complete history was taken either from patient or accompanying attendants. Total 60cases were included in this study.
A cross-sectional retrospective study was carried out at the Bangabandhu Sheikh Mujib Medical University, Dhaka to determine the diagnostic significance of platelet indices in ITP.
0 kommentar(er)
