Introduction: Thrombocytopenia, a frequent finding in haematology, often necessitates comprehensive investigations to determine its underlying cause. The Immature Platelet Fraction (IPF) has emerged as a potential diagnostic marker for thrombocytopenia associated with increased thrombopoietic activity.
Aim: This study aimed to evaluate the diagnostic utility of IPF in
differentiating thrombocytopenia due to increased thrombopoietic activity and
to assess potential variations in IPF by age and sex.
Methods: This prospective observational study included 100
patients with thrombocytopenia who were classified into two groups: those with
and without increased thrombopoietic activity. Peripheral blood samples were
analyzed using a Full Blood Count (FBC) analyzer capable of measuring IPF.
Statistical analysis was conducted using SPSS version 20, with a p-value ≤ 0.05
considered statistically significant. Receiver Operating Characteristic (ROC)
curve analysis was employed to determine the diagnostic accuracy of IPF in
identifying thrombocytopenia associated with increased thrombopoietic activity.
Results: A total of 62 patients with thrombocytopenia without
increased thrombopoietic activity had a mean IPF of 5.59% (95% CI: 3.4–7.8). In
contrast, the mean IPF was significantly higher at 14.38% (95% CI: 9.4–19.4)
among 38 patients with thrombocytopenia and increased thrombopoietic activity
(p = 0.00). An IPF cut-off value of 8% demonstrated a sensitivity of 100%,
specificity of 87%, a positive predictive value (PPV) of 82%, and a negative
predictive value (NPV) of 100%. No statistically significant differences in IPF
were observed across age or sex groups.
Discussion: The findings indicate that IPF is a reliable screening
tool for differentiating between thrombocytopenia with high and low
thrombopoietic activity. The high sensitivity and specificity of the IPF
cut-off value of 8% underscore its diagnostic utility. These results align with
previous studies highlighting the clinical relevance of IPF in assessing
platelet production dynamics. The absence of significant differences based on
age or sex suggests that IPF can be broadly applied across diverse patient
populations.
Conclusion: IPF, as determined by automated analyzers, is an
effective diagnostic marker for evaluating thrombocytopenia. An IPF value
greater than 8% provides excellent sensitivity and good specificity for
identifying thrombocytopenia associated with increased thrombopoietic activity,
making it a valuable tool for guiding clinical decision-making. Future research
may focus on integrating IPF into routine diagnostic workflows and exploring
its application in broader haematological conditions.
Author
(s) Details
C C Kariyawasan
Department of Haematology, Sri Jayewardenepura General Hospital and Post
Graduate Training Institute, Thalapathpitiya Nugegoda, Sri Lanka.
C S Botenne
Department of Haematology, Sri Jayewardenepura General Hospital and Post
Graduate Training Institute, Thalapathpitiya Nugegoda, Sri Lanka.
B L T Balasuriya
Department of Haematology, Sri Jayewardenepura General Hospital and Post
Graduate Training Institute, Thalapathpitiya Nugegoda, Sri Lanka.
U S Ruhunuhewa
Department of Haematology, Sri Jayewardenepura General Hospital and Post
Graduate Training Institute, Thalapathpitiya Nugegoda, Sri Lanka.
D M C Dissanayake
Department of Haematology, Sri Jayewardenepura General Hospital and Post
Graduate Training Institute, Thalapathpitiya Nugegoda, Sri Lanka.
S A C D Ranatunga
Department of Haematology, Sri Jayewardenepura General Hospital and Post
Graduate Training Institute, Thalapathpitiya Nugegoda, Sri Lanka.
Please see the book here:- https://doi.org/10.9734/bpi/acmms/v9/3581
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