Age- and sex-related variations in platelet count in Italy: a proposal of reference ranges based on 40987 subjects' data

BACKGROUND AND OBJECTIVES: Although several studies demonstrated that platelet count is higher in women, decreases with age, and is influenced by genetic background, most clinical laboratories still use the reference interval 150-400×10(9) platelets/L for all subjects. The present study was to identify age- and sex-specific reference intervals for platelet count. METHODS: We analysed electronic records of subjects enrolled in three population-based studies that investigated inhabitants of seven Italian areas including six geographic isolates. After exclusion of patients with malignancies, liver diseases, or inherited thrombocytopenias, which could affect platelet count, reference intervals were estimated from 40,987 subjects with the non parametric method computing the 2.5° and 97.5° percentiles. RESULTS: Platelet count was similar in men and women until the age of 14, but subsequently women had steadily more platelets than men. The number of platelets decreases quickly in childhood, stabilizes in adulthood, and further decreases in oldness. The final result of this phenomenon is that platelet count in old age was reduced by 35% in men and by 25% in women compared with early infancy. Based on these findings, we estimated reference intervals for platelet count ×10(9)/L in children (176-452), adult men (141-362), adult women (156-405), old men (122-350) and, old women (140-379). Moreover, we calculated an extended reference interval that takes into account the differences in platelet count observed in different geographic areas. CONCLUSIONS: The age-, sex-, and origin-related variability of platelet count is very wide, and the patient-adapted reference intervals we propose change the thresholds for diagnosing both thrombocytopenia and thrombocytosis in Italy

To study relation of haemoglobin level and platelet count

Background: The relationship between haemoglobin level and platelet count was carried among 116 volunteer with respect to differences between platelet count within haemoglobin (gm%) level within platelet count.Methods: Blood samples were collected into EDTA anticoagulant bulbs for both platelet count and haemoglobin level from healthy subjects.Results: Statistical analysis showed significant differences (p<0.05) between haemoglobin level that fell within platelet count 1.5 to 2.5 lacs/mm3 as (11.7±1.62) and haemoglobin level that fell within platelet count 2.51-4 lacs/mm3 as (9.1±2.40). statistical analysis also show a significant difference (p<0.05) between platelet count that fell within the haemoglobin level less than 11 gm% as (2.62±0.86) and platelet count that fell within haemoglobin level of 11-16 gm% as (2.11±0.42).Conclusions: The above results indicate that there is a relationship between low and high level of haemoglobin on platelet count and vice versa

Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Count and Plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study

Background: Thrombocytopenia has been shown to predict mortality. We hypothesize that platelet indices may be more useful prognostic indicators. Our study subjects were children one month to 14 years old admitted to our hospital.Aim: To determine whether platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) and their ratios can predict mortality in hospitalised children.Methods: Children who died during hospital stay were the cases. Controls were age matched children admitted contemporaneously. The first blood sample after admission was used for analysis. Receiver operating characteristic (ROC) curve was used to identify the best threshold for measured variables and the ratios studied. Multiple regression analysis was done to identify independent predictors of mortality.Results: Forty cases and forty controls were studied. Platelet count, PCT and the ratios of MPV/Platelet count, MPV/PCT, PDW/Platelet count, PDW/PCT and MPV x PDW/Platelet count x PCT were significantly different among children who survived compared to those who died. On multiple regression analysis the ratio of MPV/PCT, PDW/Platelet count and MPV/ Platelet count were risk factors for mortality with an odds ratio of 4.31(95% CI, 1.69-10.99), 3.86 (95% CI, 1.53-9.75), 3.45 (95% CI, 1.38-8.64) respectively. In 67% of the patients who died MPV/PCT ratio was above 41.8 and PDW/Platelet count was above 3.86. In 65% of patients who died MPV/Platelet count was above 3.45.Conclusion: The MPV/PCT, PDW/Platelet count and MPV/Platelet count, in the first sample after admission in this case control study were predictors of mortality and could predict 65% to 67% of deaths accurately.Keywords: SICK Score, PRISM, severity of illness scores PIM, in-hospital mortality; platelet indice

Utility of platelet count and platelet indices as a prognostic indicator in pregnancy induced hypertension

Background: Changes in the hemostatic system are observed in both normal and hypertensive pregnant patients. Although the exact pathophysiology of pregnancy induced hypertension is not completely understood, numerous pathophysiological mechanisms, alone or in combination, have been suggested to be responsible for the diverse subsets of PIH.Methods: This was a prospective case control study conducted on 100 pregnant females (50 PIH and 50 normotensive) at Holy Family Hospital, New Delhi, from October 2020 to May 2021. platelet count and platelet indices (mean platelet volume and ratio of platelet count to mean platelet volume) at 32 weeks and at time of delivery were checked and Outcomes were compared.Results: For predicting PIH, platelet count showed sensitivity of 82% and specificity of 54%, MPV sensitivity of 54% and specificity of 82%, PC/MPV sensitivity of 82% and specificity of 62%. For predicting pre-eclampsia without severe symptoms, platelet count showed sensitivity of 89.47% and specificity of 47.62%, mean platelet volume sensitivity of 47.37% and specificity of 76.19%, platelet count/mean platelet volume sensitivity of 31.58% and specificity of 100%. We also found that in predicting pre-eclampsia with severe symptoms platelet count showed a sensitivity of 100% and specificity of 26.32%, whereas, mean platelet volume showed equal sensitivity and specificity of 55.56%, platelet count/mean platelet volume with sensitivity of 44.44% and specificity of 84.21%.Conclusions: We found that platelet count and platelet count/mean platelet volume decreases while mean platelet volume increases with severity of pregnancy induced hypertension

Intracranial haemorrhage in a dobermann puppy with von Willebrand's disease

Neurological examination of a lethargic, ataxic 12-week-old dobermann revealed decreased conscious proprioception in all its limbs. Haematological examination revealed a low platelet count. Cytological examination of a sample of cerebrospinal fluid revealed evidence of haemorrhage and chronic inflammation. The levels of von Willebrand's factor antigen were extremely low. Skull radiographs were consistent with mild hydrocephalus. Treatment resulted in little clinical improvement and the animal was euthanased. Post mortem examination of the brain revealed an internal hydrocephalus with haemorrhage into the ventricles. It was considered that the animal had suffered severe intracranial haemorrhage as a result of its low level of von Willebrand's factor antigen and that the bleeding may have been potentiated by the low platelet count

HEPATIC DYSFUNCTION IN DENGUE: A TERITARY CARE HOSPITAL EXPERINCE

Objective: The objective of the study was to evaluate liver dysfunction in patients with dengue infections and corelation between liver function test and platelet count. Methods: Hospital-based case−control study conducted on 141 hospitalized with Dengue infection (NS 1 and IgM positive). Dengue seropositive patients are selected and subjected to complete blood count and liver function tests were analyzed. Results: The participants were found to have elevated levels of SGOT, SGPT levels, and lower levels of serum albumin and platelet count as compare to control on evaluation. The significant negative correlation was noted between SGOT/SGPT levels and baseline platelet counts levels. The Pearson correlation between platelet count and SGOT showed r=−0.185 and p&lt;0.01 which proves that when platelet count decreases, the SGOT levels increases. Similarly, for the correlation between platelet count and SGPT showed r=−0.166 and &lt;0.01 which proves that when platelet count decreases, the SGPT levels increase. Conclusion: Statistically significant corelation was observed between liver enzymes with platelet count. Furthermore, the severity of dengue infection predicted the severity of liver derangements. It is recommended that patients with dengue infections be screened for hepatic dysfunction. As hepatic dysfunction in dengue is transient and reversible, early identification of the same would help to reduce life threatening complications

Function and Platelet Count in Thrombocyte Concentrate (TC) During the Storage

Background: Evaluation for platelet transfusion is not optimal for this moment even in upstream at theblood center or in downstream at the hospital. The purpose of this study was to determine the effect ofstorage time to changes in pH, platelet count and function that occurs on platelet aggregation duringdifferent time storage.Methods: The study design was cross-sectional on selected bags of platelet concentrates that have passedthe screening for infection transmitted through blood transfusions. The regular assessment in UTDD forPC has been done every month by random sampling with three parameters pH, platelets count and volumein the bag of blood. The testing for pH, platelet count, and aggregation functions for 50 samples with threedifferent test time were conducted on day 0, third day, and fifth day storage.Results: On 50 bags samples, pH, and number of platelets increased, but the platelet aggregation functiondecreased on the third day of storage. On the fifth day of storage the pH, number of platelets and theplatelets aggregation function decreased and found the lowest number almost in all samples.Conclusion: The three parameters: pH, platelet counts, and aggregation functions decreased on the fifthday of storage. (Health Science Journal of Indonesia;2015;6:48-51

Hubungan antara Derajat Keparahan Malaria dengan Jumlah Trombosit pada Pasien Malaria di RSU Bethesda Serukam Kabupaten Bengkayang Periode 2009 2012

Background: Malaria is a parasitic haematological infectious diseasewhich could influence platelet count on the infected patient. Some studiesstated that platelet was involved in severe malaria pathogenesis. BethesdaSerukam Hospital is located in Bengkayang, the endemic site of malaria.Objective: The objective of this research was to find relationship betweenthe severity of malaria(severe malaria and uncomplicated malaria)withplatelet count. Method: This research was an analytic observational studywith cross sectional approach. The data were collected from medical recordof the patients at Bethesda Serukam Hospital. The information collectedfrom data were malaria diagnosis and platelet count of 125 malaria patients.Then the data were analyzed by using Chi-Square test. Result: Thisresearch found that 33(26,4%)malaria patients had low platelet count and23(18,4%)malaria patients had severe malaria complication. There was asignificant relationship between the severity of malaria with platelet count(p = 0,000). And based on the malaria species, there were a significantrelationship between severity of malaria caused by falciparum malaria(p= 0,001)and mixed infection(p = 0,048)with platelet count. Conclusion:The low platelet count is a common finding in severe malaria patient atBengkayang. The low platelet count was significantly associated withsevere malaria, especially severe falciparum malaria.Keyword: malaria, severe malaria, platelet count1)Medical School, Faculty of Medicine, Tanjungpura University, Pontianak,West Borneo2)Department of Community Medicine, Medical School, Faculty ofMedicine, Tanjungpura University, Pontianak, West Borneo3)Department of Parasitology, Medical School, Faculty of Medicine,Tanjungpura University, Pontianak, West Borne

The Impact of Prepartum Platelet Count on Postpartum Blood Loss and Its Association with Coagulation Factor XIII Activity

BACKGROUND Postpartum hemorrhage is a leading cause of maternal morbidity and mortality worldwide. Contradictory information exists regarding the relevance of prepartum platelet count on postpartum hemorrhage. We have shown prepartum coagulation factor XIII to be associated with postpartum blood loss; however, little is known about the association of platelet count with factor XIII activity. Our objectives were, first, to evaluate the impact of prepartum platelet count on measured postpartum blood loss in the context of prepartum measurements of coagulation factors I, II, and XIII and, second, to evaluate the association of platelet count with coagulation factor XIII, both pre- and postpartum. MATERIAL AND METHODS This is a secondary analysis of a prospective cohort study (PPH 1,300 study) which analyzed the impact of prepartum blood coagulation factors on postpartum blood loss in 1,300 women. Blood loss was quantified using a validated technique. The impact of prepartum platelet count on measured blood loss was assessed by continuous outcome logistic regression; the association of platelet count with factor XIII activity by Spearman rank correlation. RESULTS Prepartum platelet count was significantly associated with measured postpartum blood loss: every one unit (G/L) increase in prepartum thrombocytes was associated with an odds ratio of 1.002 (95% confidence interval, 1.001-1.004, p = 0.005) to keep blood loss below any given cut-off level. This means that the probability of postpartum hemorrhage decreases with increasing prepartum platelet levels. Moreover, a significant association of platelet count with factor XIII activity was shown (Spearman rank correlation coefficient for prepartum values 0.228, p < 0.001, and for postpartum values 0.293, p < 0.001). DISCUSSION/CONCLUSION The significant association of prepartum platelet count and postpartum blood loss as well as the association of platelet count with blood coagulation factor XIII activity support the likely role of platelets in preventing postpartum hemorrhage and support the new guidelines for the treatment of postpartum hemorrhage in Germany, Austria, and Switzerland, which calls for optimizing platelet counts peripartally in case of postpartum hemorrhage. A possible effect of platelets on the level of circulating factor XIII cannot be ruled out and should prompt further investigation

Platelet count estimation: a prognostic index in pregnancy induced hypertension

Background: Hypertension in pregnancy is one of the serious complications of pregnancy with an incidence of 5% to 7% of all pregnancies, particularly in cases with preeclampsia and eclampsia. Though platelet count during pregnancy is within the normal non pregnant reference values, there is a tendency for the platelet count to fall in late pregnancy. The frequency and intensity of maternal thrombocytopenia varies and is dependent on the intensity of the disease process and duration of PIH syndrome.Methods: A prospective observational study was conducted on 200 pregnant women attending OPD Or Inpatients in the Department of Obstetrics and Gynecology, SMGS Hospital, GMC Jammu from November 2015 to October 2016. Pregnant women beyond 28 weeks gestation of pregnancy are included and divided into two groups i.e. the study and control group. Platelet counts will be done every 4 weeks in controls and weekly in subjects from 28 weeks till delivery.Results: The mean platelet count observed among cases of mild preecclampsia, severe preeclampsia and ecclampsia was 2.26, 1.63 and 0.99 lakh/mm3 respectively. The difference in mean platelet count among cases and controls was statistically significant. The association of platelet count with severity of different categories of PIH was analysed statistically and was highly significant.Conclusions: Platelet count is a very important investigation for the antenatal mother having PIH, as it is directly related to maternal and perinatal outcome. Routine and regular monitoring of platelet count can be included in the routine antenatal checkup among the pregnant women with PIH