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Category: Volume 06 Issue 08 August 2018
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Title: Immature Platelet Fraction as a Prognostic Indicator of Platelet Recovery in Patients with Thrombocytopenia – An Observational Study

Authors: Roshan Paul Mampilly, Jerry George Earali, Anil Kumar CR, Joe Thomas

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.98

Abstract

Background & Objectives: Immature Platelets or Reticulated Platelets (RP) are newly released platelets which are larger and more reactive than mature platelets and contain RNA. Immature Platelet Fraction (IPF) is the percentage of RPs. It reflects the severity of damage to platelets and the generation of platelets in bone marrow. The objective of the study was to assess whether IPF could potentially be used as a prognostic indicator of platelet recovery in patients with thrombocytopenia.

Methods: This is a prospective observational study in 141 eligible patients who were followed up over a period of 5 days. Serial monitoring of platelet count and IPF were conducted on 1st,3rd and 5thday. An IPF value of >6.1% was considered as high. An increase of platelet count of 20,000cells/μL was considered as significant. The study population was grouped based on clinical diagnosis, aetiology of thrombocytopenia and severity of thrombocytopenia. Descriptive and inference analysis were done. Correlation between change in platelet count with respect to change in IPF was analysed.

Results and Discussion: Of 141 patients 68.1% were males and 31.9 % were females. Majority of the patients belonged to age group 21-40 years (42.6%). Dengue was diagnosed in 68.1% of the total patients. Pearson correlation coefficient between change in IPF and change in platelet counts on day1, day3 and day5 were -0.393, -0.455 and -0.393 respectively. IPF had an inverse correlation with respect to platelet counts. p-value obtained was <0.001 which was statistically significant. Kruskal-Wallis Test was done to find if there is any significant difference in IPF among the aetiologies. The p-value obtained was 0.003 which was statistically significant. Hence pair wise comparison of different aetiologies was done. It was found that peripheral destruction of platelets had a significant association with IPF compared to all other aetiologies.

Conclusion: There was a moderate inverse correlation between IPF and platelet counts. As the IPF levels fell, platelet levels tended to increase. It had some predictive value in anticipating platelet recovery. In thrombocytopenia, due to peripheral destruction IPF can potentially be used as a screening test.

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Corresponding Author

Roshan Paul Mampilly

Junior Resident, Department of Medicine, JMMC and RI, Thrissur