Interpretation of Platelet Histograms and Its Correlation with Peripheral Smear in Data Showing Thrombocytopenia

Aparna Shinde, Alisha Modi, Amruta Patil

Abstract


Objective: To analyze the significance of platelet histograms and peripheral smears in understanding thrombocytopenia and compare them for the incidence of pseudothrombocytopenia.

Methods: This prospective study was conducted in the Department of Pathology at a tertiary care medical institute. The study included 200 cases of thrombocytopenia. Platelet parameters (PCT, PDW, MPV) were obtained using an autoanalyzer, and peripheral smears were examined manually. Thrombocytopenia cases were classified into hyper-destructive, hypo-productive, and abnormal pooling categories based on etiology and platelet histogram patterns. The incidence of pseudothrombocytopenia was also compared. A P value of less than 0.05 was considered statistically significant.

 Results: The gender distribution showed a male preponderance (56% male, 44% female). The mean age of the patients was 26.8 years. The study found hyper-destructive thrombocytopenia to be the most common type, with viral fever, sepsis, and malaria being the common etiologies for this type of thrombocytopenia. Histogram analysis revealed distinct patterns for different types of thrombocytopenia. The study also noted a higher incidence of pseudothrombocytopenia in automated analysis compared to manual methods, with a statistically significant difference.

Conclusion: Platelet histograms combined with peripheral smear analysis provide crucial information about the etiology and nature of thrombocytopenia. This integrated approach enhances diagnostic accuracy and aid in effective patient management.


Keywords


Peripheral Smear; Platelet Histogram; Pseudothrombocytopenia; Thrombocytopenia

Full Text:

PDF

References


  1. Jinna S, Khandhar PB. Thrombocytopenia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 4, 2023.
  2. Golwala ZM, Shah H, Gupta N, Sreenivas V, Puliyel JM. Mean platelet volume (MPV), platelet distribution width (PDW), platelet count and plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study. Afr Health Sci. 2016;16(2):356–62. doi:10.4314/ahs.v16i2.3
  3. Asad S, Ahmed I, Ali N. Utility of peripheral film findings and its correlation with automated analyzer - an audit from Tertiary Care Hospital. J Lab Physicians. 2017;9(1):1–4. doi:10.4103/0974-2727.189233
  4. Schlappi C, Kulkarni V, Palabindela P, et al. Outcomes in mild to moderate isolated thrombocytopenia. Pediatrics. 2018;142(1):e20173804. doi:10.1542/peds.2017-3804
  5. Thachil J, Bates I. Approach to the diagnosis and classification of blood cell disorders. Dacie and Lewis Practical Haematology. 2017;497–510. doi:10.1016/B978-0-7020-6696-2.00023-0
  6. Gauer RL, Whitaker DJ. Thrombocytopenia: evaluation and management. Am Fam Physician. 2022;106(3):288-298.
  7. Sachs UJ. Diagnosing immune thrombocytopenia. Hamostaseologie. 2019;39 (3):250–8. doi:10.1055/s-0039-1678739
  8. Santoshi RK, Patel R, Patel NS, Bansro V, Chhabra G. A comprehensive review of thrombocytopenia with a spotlight on intensive care patients. Cureus. 2022;14(8):e27718. Published 2022 Aug 5. doi:10.7759/cureus.2771
  9. Lardinois B, Favresse J, Chatelain B, Lippi G, Mullier F. Pseudothrombocytopenia-a review on causes, occurrence and clinical implications. J Clin Med. 2021;10(4):594. Published 2021 Feb 4. doi:10.3390/jcm10040594
  10. Al-Hosni ZS, Al-Khabori M, Al-Mamari S, et al. Reproducibility of manual platelet estimation following automated low platelet counts. Oman Med J. 2016;31(6):409–13. doi:10.5001/omj.2016.83
  11. Bowen RA, Remaley AT. Interferences from blood collection tube components on clinical chemistry assays. Biochem Med (Zagreb). 2014;24(1):31–44. Published 2014 Feb 15. doi:10.11613/BM.2014.006
  12. Saran K, Vidya K, Seema K, Prasad A, Prakash J. Study of platelet indices and their role in evaluation of thrombocytopenia. J Family Med Prim Care. 2022;11(10):6236–42. doi:10.4103/jfmpc.jfmpc_460_22
  13. Vara Prasad BM, Atira Mirza, Mangalagouri SR. Spectrum of platelet histograms in adult thrombocytopenia. Int J Health Sci Res. 2024; 14(1):114–8. DOI:https://doi.org/10.52403/ijhsr.20240115
  14. Gulati G, Uppal G, Gong J. Unreliable automated complete blood count results: causes, recognition, and resolution. Ann Lab Med. 2022;42(5):515–30. doi:10.3343/alm.2022.42.5.515
  15. Saran K, Vidya K, Seema K, Prasad A, Prakash J. Study of platelet indices and their role in evaluation of thrombocytopenia. J Family Med Prim Care. 2022;11(10):6236–42. doi: 10.4103/jfmpc.jfmpc_460_22.
  16. Sandhya V, Rashmi GSB, Correlation of peripheral smear with RBC indices and RBC histograms in the diagnosis of anemia, Indian Journal of Pathology and Oncology, April-June 2017;4(2):242–6.
  17. Patel J, S. N. Baxi, Lalji G.valiya, Evaluation of etiological differences in thrombocytopenia in underdeveloped country . IOSR J Dental Medical Sciences. 2015:14(12):31–3.
  18. Gauer RL, Whitaker DJ. Thrombocytopenia: evaluation and management. Am Fam Physician. 2022;106(3):288–98.
  19. Fountain EM, Arepally GM. Etiology and complications of thrombocytopenia in hospitalized medical patients. J Thromb Thrombolysis. 2017;43(4):429–36. doi:10.1007/s11239-016-1467-8
  20. Shetty A, Shubha HV, Chowdappa V, Vivek TG. A Study of variation in adult thrombocytopenic histograms. Ann Pathol Lab Med. 2020;7(2):A83–8.
  21. Walle M, Arkew M, Asmerom H, Tesfaye A, Getu F. The diagnostic accuracy of mean platelet volume in differentiating immune thrombocytopenic purpura from hypo-productive thrombocytopenia: A systematic review and meta-analysis. PLoS One. 2023;18(11):e0295011. Published 2023 Nov 30. doi:10.1371/journal.pone.0295011
  22. Bhola A, Garg R, Sharma A, Gupta N, Kakkar N. Macrothrombocytopenia: role of automated platelet data in diagnosis. Indian J Hematol Blood Transfus. 2023;39(2):284–93. doi:10.1007/s12288-022-01590-6
  23. Lardinois B, Favresse J, Chatelain B, Lippi G, Mullier F. Pseudothrombocytopenia-A review on causes, occurrence and clinical implications. J Clin Med. 2021;10(4):594. doi:10.3390/jcm10040594




DOI: https://doi.org/10.15850/ijihs.v12.n1.3773

Article Metrics

Abstract view : 435 times
PDF - 155 times


 

This Journal indexed by

                   

 


Creative Commons License
IJIHS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License



View My Stats