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Immature Platelet Fraction: Its Clinical Utility in Thrombocytopenia Patients

Authors
  • Goel, Garima1
  • Semwal, Shruti2
  • Khare, Akriti3
  • Joshi, Deepti1
  • Amerneni, Chaitanya K.4
  • Pakhare, Abhijit5
  • Kapoor, Neelkamal1
  • 1 Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
  • 2 Department of Pathology, L.N. Medical College and J.K. Hospital, Bhopal, Madhya Pradesh, India
  • 3 Department of Hematology, All India Institute of Medical Sciences, Delhi, India
  • 4 Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
  • 5 Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
Type
Published Article
Journal
Journal of Laboratory Physicians
Publisher
Thieme Medical and Scientific Publishers Pvt. Ltd.
Publication Date
Jun 15, 2021
Volume
13
Issue
3
Pages
214–218
Identifiers
DOI: 10.1055/s-0041-1729471
PMID: 34602784
PMCID: PMC8478497
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distinguished for appropriate management. Newly formed immature platelets are called reticulated platelets (RPs) and can be estimated in peripheral blood using automated hematology analyzers, which express them as immature platelet fraction (IPF). In the present study we intend to assess and establish the clinical utility of IPF in differentiating the two major causes of thrombocytopenia—decreased production and increased destruction of platelets—along with determining its significance in monitoring patients with thrombocytopenia. Materials and Methods Sixty-one cases of thrombocytopenia and 101 healthy controls with normal platelet count were included in the study. IPF and all the other usual blood cell parameters were measured using a fully automated hematology analyzer. Based on the pathogenesis of thrombocytopenia, the cases were divided into groups and the difference in IPF value between the groups was evaluated. Results The reference range of IPF among healthy controls was estimated to be 0.7 to 5.7%. The mean IPF was significantly higher in patients with increased peripheral destruction of platelets (13.4%) as compared to patients with decreased production of platelets (4.6%). The optimal cutoff value of IPF for differentiating patients with increased peripheral destruction of platelets from patients with decreased production of platelets was 5.95% with a sensitivity of 88% and specificity of 75.9%. Conclusion Measurement of IPF is useful for detecting evidence of increased platelet production and helps in the initial evaluation of thrombocytopenia patients. It is a novel diagnostic method which can be used to differentiate patients with thrombocytopenia due to increased destruction of platelets from patients with thrombocytopenia due to bone marrow failure/suppression.

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