Platelet size for distinguishing between inherited thrombocytopenias and immune thrombocytopenia: A multicentric, real life study

Patrizia Noris, Catherine Klersy, Paolo Gresele, Fiorina Giona, Paola Giordano, Pietro Minuz, Giuseppe Loffredo, Alessandro Pecci, Federica Melazzini, Elisa Civaschi, Annamaria Mezzasoma, Monica Piedimonte, Fabrizio Semeraro, Dino Veneri, Francesco Menna, Laura Ciardelli, Carlo L. Balduini

Research output: Contribution to journalArticle

Abstract

The most frequent forms of inherited thrombocytopenia (IT) are characterized by platelet size abnormalities and it has been suggested that this parameter is useful for their differentiation from immune thrombocytopenia (ITP). Recently, a monocentric study identified cut-off values for mean platelet volume (MPV) and mean platelet diameter (MPD) with good diagnostic accuracy in this respect. To validate these cut-off values in a different and larger case series of patients, we enrolled 130 subjects with ITP and 113 with IT in six different centres. The platelet count and MPV was each measured by the instrument routinely used in each institution. In some centres, platelet count was also measured by optical microscopy. MPD was evaluated centrally by image analysis of peripheral blood films. The previously identified cut-off value for MPV had 91% specificity in distinguishing ITP from inherited macrothrombocytopenias (mono and biallelic Bernard-Soulier, MYH9-related disease), while its sensitivity was greatly variable depending on the instrument used. With an appropriate instrument, specificity was 83%. The diagnostic accuracy of MPD was lower than that obtained with MPV. We concluded that MPV is a useful parameter for differentiating ITP from IT provided that it is measured by appropriate cell counters.

Original languageEnglish
Pages (from-to)112-119
Number of pages8
JournalBritish Journal of Haematology
Volume162
Issue number1
DOIs
Publication statusPublished - Jul 2013

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Keywords

  • Immune thrombocytopenia
  • Inherited thrombocytopenias
  • Platelet diameter
  • Platelet size
  • Platelet volume

ASJC Scopus subject areas

  • Hematology

Cite this

Noris, P., Klersy, C., Gresele, P., Giona, F., Giordano, P., Minuz, P., Loffredo, G., Pecci, A., Melazzini, F., Civaschi, E., Mezzasoma, A., Piedimonte, M., Semeraro, F., Veneri, D., Menna, F., Ciardelli, L., & Balduini, C. L. (2013). Platelet size for distinguishing between inherited thrombocytopenias and immune thrombocytopenia: A multicentric, real life study. British Journal of Haematology, 162(1), 112-119. https://doi.org/10.1111/bjh.12349