Butt Aqsa Javed, Zaidi Uzma, Munawar Ali Rabeea, Zafar Sidra, Ali Muhammad Shujat, Shamsi Tahir
Clinical Hematology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, PAK.
Research and Development, National Institute of Blood Diseases and Bone marrow Transplantation, Karachi, PAK.
Cureus. 2023 Jul 4;15(7):e41346. doi: 10.7759/cureus.41346. eCollection 2023 Jul.
This study aimed to compare the reticulated platelet count between patients having thrombocytopenia secondary to autoimmune destruction (immune thrombocytopenia {ITP}), bone marrow failure, and healthy controls who presented to a tertiary care hospital in Karachi, Pakistan.
A cross-sectional study was conducted from February 2021 to October 2022 in the Department of Hematology, National Institute of Blood Disease (NIBD) Hospital in Karachi, Pakistan, that involved examining three groups: 30 patients with immune thrombocytopenia, 30 patients with thrombocytopenia secondary to reduced production from bone marrow, and 30 healthy controls. The study utilized the Sysmex XN-1000 (Hyogo, Japan: Sysmex Corporation) automated hematology analyzer to perform a complete blood count (CBC) test. Additionally, peripheral blood was stained with Leishman stain and examined under a microscope to eliminate pseudo thrombocytopenia and identify any abnormal cells or dysplasia. The immature platelet fraction (IPF) was then performed on Sysmex XN 1000 after ensuring adequate quality control. Finally, the data were analyzed using DATAtab (Graz, Austria: DATAtab) and SPSS version 25 (Armonk, NY: IBM Corp.).
Of the ninety participants, the median age was 33 years with a range of 18-71 years. Patients with ITP had a significantly higher median IPF% (median=26.65, IQR=15-39.4) than thrombocytopenia due to bone marrow failure (median=9.25, IQR=4.55-14.30) and healthy controls (median=7, IQR=4.40-9.90), with a p-value of 0.001. The immune thrombocytopenia group demonstrated an increase in IPF% as platelet counts increased, indicating a significant moderate correlation between IPF% and platelets in these patients (r=0.438, p=0.016) and confirming that IPF% was an independent predictor for the detection of ITP.
Reticulated platelet count may be a useful diagnostic tool to differentiate between ITP and thrombocytopenia caused by bone marrow failure. Because of its non-invasive nature, IPF is a valuable tool for expediting the management of thrombocytopenia associated with increased IPF.
本研究旨在比较巴基斯坦卡拉奇一家三级护理医院中，因自身免疫性破坏导致血小板减少的患者（免疫性血小板减少症{ITP}）、骨髓衰竭患者与健康对照者的网织血小板计数。
2021年2月至2022年10月，在巴基斯坦卡拉奇国家血液疾病研究所（NIBD）医院血液科进行了一项横断面研究，涉及三组：30例免疫性血小板减少症患者、30例因骨髓生成减少导致血小板减少的患者和30名健康对照者。该研究使用Sysmex XN - 1000（日本兵库：Sysmex公司）全自动血液分析仪进行全血细胞计数（CBC）检测。此外，外周血用利什曼染色并在显微镜下检查，以排除假性血小板减少症，并识别任何异常细胞或发育异常。在确保足够质量控制后，在Sysmex XN 1000上进行未成熟血小板分数（IPF）检测。最后，使用DATAtab（奥地利格拉茨：DATAtab）和SPSS 25版（纽约阿蒙克：IBM公司）对数据进行分析。
在90名参与者中，年龄中位数为33岁，范围为18 - 71岁。ITP患者的IPF%中位数（中位数 = 26.65；四分位间距[IQR]=15 - 39.4）显著高于骨髓衰竭导致血小板减少的患者（中位数 = 9.25；IQR = 4.55 - 14.30）和健康对照者（中位数 = 7；IQR = 4.40 - 9.90），p值为0.001。免疫性血小板减少症组的IPF%随着血小板计数增加而升高，表明这些患者的IPF%与血小板之间存在显著的中度相关性（r = 0.438；p = 0.016），并证实IPF%是检测ITP的独立预测指标。
网织血小板计数可能是区分ITP和骨髓衰竭所致血小板减少症的有用诊断工具。由于其非侵入性，IPF是加速管理与IPF增加相关的血小板减少症的有价值工具。
