Saadet AKARSU, Yaşar ŞEN, Abdullah KURT, Çıtak A. Neşe KURT, İlknur VAROL

Değişik hastalık gruplarında trombosit hacim değişkenleri

Amaç: Değişik hastalıklarda trombosit hacim değişkenlerinin (ortalama trombosit hacimi [MPV], trombosit dağılım aralığı [PDW]) değerlerini belirlemek istedik. Bu şekilde, doğrudan kemik iliğinden kaynaklanan hastalıkların; tanı sırasında birbirleriyle ayırıcı tanısının sağlanması ve sistemik hastalıkların trombositler üzerine etkileri belirlenmek istenildi. Gereç ve Yöntem: Üç yıllık sürede kliniğimizde takip edilen, 452 akut veya kronik olgunun kayıtları geriye dönük olarak incelendi. Olgular kan hastalıkları, sistemik hastalıklar ve entoksikasyonlar olarak üç gruba ayrıldı. Bulgular: Çalışmaya alınan 452 hastanın 245'i (%54) erkek, 207'si (%46) kız idi. Hastaların yaş ortalaması 87,1±58,2 (1-216) ay idi. MPV değeri kan hastalıklarında 7,6±1,4 fl, sistemik hastalıklardan kalp hastalıklarında 7,8±1,1 fl, böbrek hastalıklarında 7,2±1,0 fl, endokrin hastalıklarda 8,2±1,4 fl, alerjik hastalıklarda 6,7±0,4 fl ve entoksikasyonda 7,8±1,5 fl olarak saptandı. MPV açısından gruplar arasında istatistiksel anlamlı fark yoktu (p>0,05). PDW değeri kan hastalıklarında 14,6±3,1 fl, sistemik hastalıklardan kalp hastalıklarında 17,6±4,0 fl, böbrek hastalıklarında 17,8±5,7 fl, endokrin hastalıklarda 16,4±1,8 fl, alerjik hastalıklarda 15,9±0,5 fl ve entoksikasyonda 16,9±0,6 fl olarak saptandı. PDW değerleri açısından kan hastalıkları ve sistemik hastalıklar arasında kan hastalıkları ve entoksikasyonlar arasında istatistiksel anlamlı fark vardı (p

Thrombocyte volume parameters in different disease groups

Aim: We aimed to determine the values of thrombocyte volume parameters (mean platelet volume (MPV(, platelet distribution width (PDW() in different diseases. In this way, we aimed to ensure differential diagnosis in the diseases directly caused by bone marrow during the diagnosis process and to determine the effects of the systemic diseases on thrombocytes. Material and Method: The records of 452 acute or chronic cases who have been followed in our clinic for three years were reviewed retrospectively. The cases were divided into three groups as hematological diseases, systemic diseases and intoxications. Results: Of the 452 patients taken into this study, 245 (54%) were boys, 207 (46%) were girls. The medium age of the patients was 87.1±58.2 (1-216) months. The MPV values were determined to be as 7.6±1.4, 7.8±1.1, 7.2±1.0, 8.2±1.4, 6.7±0.4 and 7.8±1.5 fl in hematological, cardiac, nephrological, endocrinological, allergic diseases, and intoxications, respectively. There was not a significant difference among the groups for MPV (p(0.05). PDW value was determined to be as 14.6±3.1, 17.6±4.0, 17.8±5.7, 16.4±1.8, 15.9±0.5 and 16.9±0.6 fl in hematological, cardiac, nephrological, endocrinological, allergic diseases, and intoxications respectively. There were significant statistical differences for PDW values between hematological and systemic diseases or intoxications (p(0.05). Conclusions: Additional studies, those include higher number of patients and those evaluate PDW values especially in hematological diseases might require. It is a remarkable fact that PDW values of thrombocytes is very important in differential diagnosis.

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1. Wilson DB. Acquired platelet defects. In: Nathan DG, Orkin SH, Ginsburg D, Look AT (eds). Nathan and Oski's Hematology of Infancy and Childhood. Philadelphia: WB Saunders Company, 2003; 1599- 600.
2. Dow RB. The clinical and laboratory utility of platelet volume parameters. Aust J Med Sci 1994; 15: 12- 5.
3. Rowan RM. Platelet size distribution analysis: principles techniques and potential clinical utility. Hematology Reviews 1986; 1: 109- 44.
4. Kim KY, Kim KE, Kim KH. Mean platelet volume in the normal state and in various clinical disorders. Yonsei Med J 1986; 27: 219- 26.
5. Graham S, Traub B, Mink IB. Automated platelet-sizing parameters on a normal population. Am J Clin Pathol 1987; 87: 365- 9.
6. Bessman JD, Gilmer PR, Gardner FH. Use of mean platelet volume improves detection of platelet disorders. Blood Cells 1985; 11: 127- 35.
7. Trowbridge EA, Reardon DM, Hutchinson D, Pickering C. The routine measurement of platelet volume: a comparison of light-scattering and aperture impedance technologies. Clin Phys Physiol Meas 1985; 6:221- 38.
8. Odell TT, Murphy JR, Jackson CW. Stimulation of megakaryocytopoiesis by acute thrombocytopenia in rats. Blood 1976; 48: 765- 75.
9. Gewirtz AM, Poncz M. Megakaryocytopoiesis and platelet production. In: Hoffman R, Benz EJ, Shattil SJ, Bruce Furie,Cohen HJ (eds). Hematology Basic Principles and Practice. New York: Churchill Livingstone, 1991; 1148- 57.
10. Tong M, Seth P, Penington DG. Proplatelets and stress platelets. Blood 1987; 69: 522- 8.
11. Thompson CB, Jakubowski JA. The pathophysiology and clinical relevance of platelet heterogenity. Blood 1988; 72: 1- 8.
12. Holme S, Simmonds M, Ballek R, Murphy S. Comparative measurements of platelet size by coulter counter microscopy of blood smears, and light transmission studies. Relationship between platelet size and shape. J Lab Clin Med 1981; 97: 610- 22.
13. Disorders of platelet size. In: Philip Lanzkowsky (ed). Manual of Pediatric Hematology and Oncology. Third Edition. Boston: Acedemic Press 2000; 233- 85.
14. Nelson RB, Kehl D. Electronically determined platelet indices in trombocytopenic patients. Cancer 1981; 48: 954- 6.
15. Tomita E, Akatsuka J, Kokubun Y. Differential diagnosis of various thrombocytopenias in childhood by analysis of platelet volume. Pediatr Res 1980; 14: 133- 7.