Mean Platelet Volume (Mpv)

MEAN PLATELET VOLUME (MPV) Introduction: Platelets are the smallest components of the blood but carry great responsibility of hemostasis. Platelets bud-off megakaryocytes in the marrow. Platelet size and volume depends on the circumstances of their production in the marrow. MPV is not related to ageing of platelets in the circulation. Platelet parameters are very stable in most patients. Their role in thrombosis, hemorrhage, tissue repair and inflammatory responses resulting into MI, stroke, DIC, etc. attracts clinician’s attention and /observation to enhance their clinical knowledge and utilization of blood physiology in diagnosis. Just like Red cell Indices, several indices are associated with platelets known as Platelet Indices. These indices have been investigated as prospective platelet markers as well. Some of the common platelet indices are MPV, PDW and P-LCR. BRIEF LIFE CYCLE OF PLATELETS: Low platelet concentration isknown as thrombocytopenia and is due to either decreased production or increased destructionof platelets. Elevated platelet concentration is known as thrombocytosis and is either congenital, reactive , or due to unregulated production: one of the myeloproliferative neoplasms or certain other myeloid neoplasms. A disorder of platelet function is a thrombocytopathy. Whenever there is increased destruction, signal is sent to bone marrow to increase the production of platelets. The MPV has usually been found to have inverse relationship with platelet number. Larger mean platelet volumes are seen in thrombocytopenic patients in whom platelets are decreased due to peripheral destruction. Definition: Mean Platelet Volume (MPV) is a measurement that describes the average size of platelet in the blood. Characteristics: 1. MPV Normal Range: 7.4 to 10.4 fL (Men & Women) 2. MPV is measured with an automatic blood cell counter and increases usually when many large platelets are present. 3. If platelet count is low and MPV is high the risk of bleeding is comparatively less and larger platelets have multifold better hemostatic capacity than normal size platelets. Common Conditions where MPV Increases Increased MPV is in conditions with increased platelet production: • Immune thrombocytopenia • Infection Related Thrombocytopenia like dengue, malaria etc. • Idiopathic Thrombocytopenic Purpura • Myeloproliferative disorders • Myelodysplasia • Sepsis • Sickle Cell Anemia • Heart Valve Prosthesis • Disseminated intravascular coagulation • Hyperthyroidism Common Conditions with decreased MPV : Decreased MPV means platelets are smaller than normal and are known as microthrombocytes. Causes may include following conditions: 1. Aplastic Anemia 2. Wiskott-Aldrich Syndrome 3. Storage pool disease 4. Megaloblastic Anemia 5. Chemotherapy 6. Hypersplenism 7. Megakaryocytic Hypoplasia Clinical Significance &Aspects Explored: Detects Blood Disorders Role of MPV in Type II Diabetes Mellitus Low MPV also results from Therapy that involves drugs toxic to platelets or megakaryocytes in the bone marrow High MPV has also been found associated with risk of myocardial infarction Confirmed correlation exists between Increased MPV and Risk of Thrombosis Medical Research shows that patients with an increased MPV of more than 11.01 fL are at higher risk of blood complications and death due to condition called ischemic heart disease . References: • Dacie and Lewis, Practical Haematology • The ABC of CBC by Dr. D. P. Lokwani • Arch Pathol Lab Med. Vol 133, September 2009; 1441-43 • ThrombHaemost. 2008, 100 Contributors: • Dr. Parag Dharap, Mumbai • NitinNayyar, Coordinator – Scientific Communications • ShubhamRastogi, AGM, Marketing, HORIBA Medical .

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