The Usefulness of the Mean Platelet Volume for Initial Diagnosis of Destructive Thrombocytopenia

Abstract

Background: Routinely, bone marrow (BM) evamination is considered to be the gold standard test for the differentiation between underproductive thrombocytopenia and destructive thrombocytopenia. In contrast to BM examination, MPV is a simple and inexpensive test which may give an initial information as BM does. Objective: To determine the diagmostic value of MPV as the initial test to ciagmose destructive thrombocytopenia. Study design: Descriptive study. Materials and methods: Between 1* of January and 31* of October 2003, all patients except megaloblastic anemia and myelodysplastio syndrome, with platelet count less than 150,000/mm' were entered the study. The mean of MPV in normal Thais (7.9 IL) was used as the reference value. The thrombocytopenio patients with MPV S7.9
I would be diagnosed as underproductive thrombocytopenia whereas the rest of them would be diagmosed as destructive thrombocytopenia. Results: 50 out of 60 patients were evaluated. As compared with BM examination, MPV >7.9 fL could prediot destructive thrombocytopenia with sensitivity of 77.5%, specifcity of 80.0%, PPV of 93.9%, NPV of 50%, accuracy of 80.0% and the optimal reference value between sensitivity and specificity of the test from ROC curve is 7.9 fL with area sensitivity of 75% and 1- specifcity of 20%. Conclusion: The mean of MPV in normal Thais (7.9 f) can be easily used as a reference value to initially diagmose destructive thrombocytopenia.