low platelets & MPV

[lindy]

I have low platelets but notice that my mean platelet volume (MPV) is high.
Does anyone has the same situation? Why is platelet count low when volume is high? Is the any relationship between the two?
Appreciate any help. Thanks.

Platelet = 103
MPV = 9.8

[Neil Cuadra]

MPV is a measure of the size of your platelets, rather than the number of your platelets.

Platelets are larger when they are first formed, so a patient with increased platelet production (lots of new platelets) or short platelet lifespans (few old platelets) would presumably have elevated MPV. A high value can be a sign of ITP (idiopathic thrombocytopenic purpura), while a low MPV is common in aplastic anemia patients.

Did your doctor or lab tell you that your MPV of 9.8 is high? From the reference ranges I've seen, you're within the normal range but on the high end within that range. Some labs consider "high" to mean anything over 10 or 11, but others may consider an MPV up to 15 to be in the normal range. In any case, the value may fluctuate from test to test so you'd want to check test results over time, not rely on a single CBC.

Given your low platelet count, it would be worth asking your doctor if your MPV measurement sheds light on your condition. If you do, please share with us what you learn!

[lindy]

Thanks Neil for your helpful comments.

I'm back from the hospital after seeing the haematologist.
My CBC is about the same as previous. Platelets still low.

I check with him & he said my MPV of 9.8 is considered high as the normal range here is usually 7-8+.
Neil, you're right, he explained about MPV & said my case at this moment is ITP. (But doesn't rule out the possibility of MDS later on)
He mentioned that the polyclinic had tested me early this year for Hepatitis & SLE which were negative. (I thought they did only CBC & blood smear)
He told me to watch out for any new symptons, then he may consider doing BMB.
If my platelets continue to remain low for another year or two he may review the need for BMB even without new symptons.

Will go back to him for another CBC next year.

[akita]

Hi Lindy,

This study -

http://ash.confex.com/ash/2010/webpr...aper34476.html | Author

2943 Platelet-Associated IgG May Be Associated with Thrombocytopenia In Patients with Myelodysplastic Syndromes

- found out that MPV was significantly higher in patients with platelet count < 100 x109/L( median, min-max: 9.38, 6.9-23.1 vs *8.46, 4.88-12.83 ; p<0.001, Wilcoxon rank sum test).

Your doctor can relatively easily find out if you belong to the group of MDS-patients where immune destruction of platelets could be an additional factor in the genesis of thrombocytopenia.

"Thus, we propose that a combination of a simple index as MPV and a highly sensitive and easy to perform screening test for PAIgG as PIFT could be applied to select a subset of MDS patients in which we would be able to prevent the overuse of unnecessary platelet transfusions and who could be candidates for an immunosuppressive therapeutic approach. "

ITP could be an approach helping you to get medicaments like NPlate, but the actual studies seem not promising the optimum of safety for MDS-patients.

Hope i could help.

Regards,

Margarete

[lindy]

Thank you akita for your help.

Trying hard to understand all the info available here.

Thanks again.

[Dick S]

On my chart, MPV shows a min/max of 9 to 12.3 and mine consistantly run right around 12, much higher than yours and they still haven't started any treatment on me.
These limits are VA/Medicare figures.

[akita]

Hi Lindy,

thank you for your interest. i have read the article again and also for me it is hard to understand, over all the practical use of the study: Is this mainly for Brazilia, to find out the immune thrombocytopenic MDs-patients from diagnosis on? If you have already big problems with your trombocytopenia and immune reactions to thrombo-concentrates, there is perhaps no doubt that you belong to the immune thrombozythopenic group..But the screening could ad least help patients at diagnosis helping to get no useless treatments.

Regards,

Margarete

[lindy]

@ akita -I'm seeing doc in a public clinic/hospital & they usually don't support any tests unless really necessary due to cost. Anyway thanks for the info.

@Dick S - sometimes it may be better not to start any treatment which may make the situation worse. You're possibly right, funding is always a issue. At least you have your own personal insurance cover. I only have a basic low public cover that most citizens get.