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[Increase in mean platelet volume in shock-related thrombocytopenia]
Abstract:
In a retrospective study the mean platelet volume (MPV) was measured in citrated plasma of 16 patients with hypovolaemic or infectious toxic shock. Bone marrow examination was carried out in most cases. Eighty p. cent of the patients had an increase in MPV, and the increase persisted even after thrombocytopenia had regressed. Cytological examination of the bone marrow failed to provide evidence that bone marrow deficiency was a predominant factor in the pathogenesis of thrombocytopenia in any of these patients. In this particular patient population, bone marrow examination should be reserved to those cases where persistent thrombocytopenia coexists with normal MPV.
Insights
Increased mean platelet volume (MPV) is common in toxic shock patients, even after platelet counts normalize. Bone marrow exams are only needed for persistent low platelets with normal MPV.
Area of Science:
- Hematology
- Critical Care Medicine
- Pathophysiology
Background:
- Thrombocytopenia is a common complication in patients with hypovolemic or infectious toxic shock.
- The underlying mechanisms of thrombocytopenia in toxic shock are not fully understood.
- Mean platelet volume (MPV) is an indicator of platelet production and activation.
Purpose of the Study:
- To investigate the changes in mean platelet volume (MPV) in patients with hypovolemic or infectious toxic shock.
- To evaluate the utility of bone marrow examination in diagnosing the cause of thrombocytopenia in these patients.
Main Methods:
- A retrospective study was conducted on 16 patients diagnosed with hypovolemic or infectious toxic shock.
- Mean platelet volume (MPV) was measured in citrated plasma.
- Bone marrow examination was performed in most patients.
Main Results:
- Eighty percent of patients exhibited an elevated MPV.
- The increased MPV persisted even after the resolution of thrombocytopenia.
- Bone marrow examination did not reveal bone marrow deficiency as a primary cause of thrombocytopenia in these patients.
Conclusions:
- Elevated MPV is a frequent finding in toxic shock syndrome and may serve as an indicator of platelet activation or consumption.
- Bone marrow examination is not routinely indicated for thrombocytopenia in toxic shock patients unless persistent thrombocytopenia is accompanied by a normal MPV.