Immature Platelet Fraction: Its Clinical Utility in Thrombocytopenia Patients

Garima Goel; Shruti Semwal; Akriti Khare; Deepti Joshi; Chaitanya K Amerneni; Abhijit Pakhare; Neelkamal Kapoor

doi:10.1055/s-0041-1729471

Immature Platelet Fraction: Its Clinical Utility in Thrombocytopenia Patients

J Lab Physicians. 2021 Sep;13(3):214-218. doi: 10.1055/s-0041-1729471. Epub 2021 Jun 15.

Authors

Garima Goel¹, Shruti Semwal², Akriti Khare³, Deepti Joshi¹, Chaitanya K Amerneni⁴, Abhijit Pakhare⁵, Neelkamal Kapoor¹

Affiliations

¹ Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
² Department of Pathology, L.N. Medical College and J.K. Hospital, Bhopal, Madhya Pradesh, India.
³ Department of Hematology, All India Institute of Medical Sciences, Delhi, India.
⁴ Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
⁵ Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Abstract

Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distinguished for appropriate management. Newly formed immature platelets are called reticulated platelets (RPs) and can be estimated in peripheral blood using automated hematology analyzers, which express them as immature platelet fraction (IPF). In the present study we intend to assess and establish the clinical utility of IPF in differentiating the two major causes of thrombocytopenia-decreased production and increased destruction of platelets-along with determining its significance in monitoring patients with thrombocytopenia. Materials and Methods Sixty-one cases of thrombocytopenia and 101 healthy controls with normal platelet count were included in the study. IPF and all the other usual blood cell parameters were measured using a fully automated hematology analyzer. Based on the pathogenesis of thrombocytopenia, the cases were divided into groups and the difference in IPF value between the groups was evaluated. Results The reference range of IPF among healthy controls was estimated to be 0.7 to 5.7%. The mean IPF was significantly higher in patients with increased peripheral destruction of platelets (13.4%) as compared to patients with decreased production of platelets (4.6%). The optimal cutoff value of IPF for differentiating patients with increased peripheral destruction of platelets from patients with decreased production of platelets was 5.95% with a sensitivity of 88% and specificity of 75.9%. Conclusion Measurement of IPF is useful for detecting evidence of increased platelet production and helps in the initial evaluation of thrombocytopenia patients. It is a novel diagnostic method which can be used to differentiate patients with thrombocytopenia due to increased destruction of platelets from patients with thrombocytopenia due to bone marrow failure/suppression.

Keywords: fraction; immature; platelet; reticulated; thrombocytopenia.

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