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TITLE:

A PROSPECTIVE STUDY TO DISCRIMINATE HYPOPRODUCTIVE THROMBOCYTOPENIA FROM HYPERDESTRUCTIVE THROMBOCYTOPENIA USING MEAN PLATELET VOLUME (MPV).

AUTHORS:

Dr Uzma Chohan, Dr Muhammad Akram, Dr Tayyaba Batool , Dr Muhammad Irfan Khan, Dr Muhammad Kashif Kamran, Dr Anila Shamim Bukhari

ABSTRACT:

Objective: to determine the diagnostic accuracy of MPV in differentiating hypersestructive thrombocytopenia from hypoproductive thrombocytopenia, keeping bone marrow examination as the gold standard diagnostic tool. Material & Methods: this crossectional validation study was conducted at the department of Pathology , Shekh Zaid Medical College and Hospital Rahim Yar Khan over a period of 6 months. A total of 200 patients 18 years and above were included in the study. Automated haematology analyser was used to measure MPV. The BM aspiration and trephine biopsy was performed by Haematologist. Data was analysed by using SPSS version 16. For quantitative variables 2X2 table was was made to calculate sensitivity, specificity, positive predictive value , negative predictive value and MPV. Results: Out of 200 patients 94 (47%) were males and 106 (53%) females. Sensitivity, specificity and diagnostic accuracy of MPV differentiating HDT and HPT was 95.7%, 67.9%, and 74.5% respectively. Positive predictive value was 47.8% and negative predictive value was 98.1%. On BM examination 47 cases were HDT and 153 were HPT. True positive cases were 45, false positive cases 49, false negative cases were 2 and true negative cases were 104. Conclusion: This study concluded that although MPV may provide a small initial insight into the aetiology of thrombocytopenia, it is limited by insufficient specificity and positive predictive value to distinguish hypoproductive from hypodestructive thrombocytopenias. A bone marrow examination continues to be the gold standard to differentiate the hypoproductive and hyperdestructive thrombocytopenias. Key words: Hypoproductive thrombocytopenia, Hyperdestructive thrombocytopenia, sensitivity, specificity, positive predictive value.

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