The main task of platelets (blood flakes), which are produced in the bone marrow and pass into the bloodstream, is to stop bleeding and lead to clot formation by closing the damaged area when any injury occurs on the vessel surface. The half-life of platelets is about 4 days, compared to 120 days of red blood cells. The vast majority of thrombocytes produced in the bone marrow are released into the bloodstream to perform their duties, while some are stored in the spleen.
When damage occurs to the surface of the vessel, blood vessels contract, prevent platelets from collecting into the damage site and form a plug. Afterwards, coagulation occurs in that area, and the area that is damaged is closed, thus saving time for repair.
Platelets generally have surface properties that will allow them to adhere to the environment they are in, but they move along the bloodstream without adhesion unless there is any damage to the vessel wall.
Although the number of platelets does not vary depending on the age, it is considered normal to determine the number as 150-400 thousand platelets per cubic millimeter. In addition to the number of platelets, the MPV Mean platelet volume can be calculated along with developing blood counting devices.
What is MPV?
Mean platelet volume (MPV), one of the most commonly used parameters for the detection of platelets-related disorders, is used to assess the size of platelets and gives an idea of the platelet production in the bone marrow. Due to the larger number of newly produced platelets, it may be a guide for the underlying cause of the change in MPV value.
What are the situations that can cause changes in MPV value?
The unit of the MPV value is femtolitre (fl) and the normal value range is between 7-11 fl.
In smokers, hypertension patients, diabetics and obese people, MPV elevation can be detected.
Increased platelet size may predispose to the occurrence of diseases related to blood vessels. In cases of stroke caused by cessation of blood flow to the brain (ischemic), MPV height can be determined in recent laboratory tests following the event.
While people with diseases that progress with inflammation in the intestines such as ulcerative colitis and Crohn’s disease, an increase in the number of platelets has brought up the idea that small platelet sizes can be used to evaluate the activation of MPV measurements.
In inflammatory disorders such as rheumatoid arthritis, ankylosing spondyloarthritis, psoriasis, familial Mediterranean fever, and Behçet’s disease, changes in MPV may occur with the destruction of platelets.
While values higher than the limit value (mpv height) occur in diseases with macrotrombocytopenia (larger than normal and fewer platelets), the detected MPV low may indicate a problem with the production of platelets in the bone marrow.
Immune (idiopathic) thrombocytopenic purpura (ITP)
This discomfort occurs after the acquired (acquired) causes and is a discomfort caused by the defense system’s struggle against its own platelets. It is mostly seen in children. Children 2-10 years old constitute the age group in which the disease is most common.
The cause of the disease is the destruction of platelets marked with antibodies produced by defense cells in organs such as the spleen and liver. The event that triggers this situation is the transmission of a disease caused by viruses in the vast majority of patients. The increase in production is tried to be balanced against the increase of destruction, and in line with the effectiveness of this effort, the degree of thrombocytopenia (low platelet count) varies from patient to patient.
Because the newly produced platelets are larger, the measured MPV values can be detected higher than normal.
The signs of the disease vary with age. The occurrence of pin-sized bleeding and bruises in a child with a good health condition is one of the common findings related to the disease. In the adult age group, symptoms do not appear sometimes and as a result of blood count tests performed for other reasons, the findings leading to this disease can be detected by chance.
During the course of the disease, caution should be exercised as serious events such as intracranial bleeding may occur in cases where the platelet count decreases excessively in addition to minor bleeding and bruises.
Bernard Soulier Syndrome
In Bernard Soulier syndrome, which is a rare and genetic transition disease due to mutations, extremely large platelets are formed and these platelets are few in number. Due to the genetic transition, it is important to examine the presence of individuals with similar ailments in the diagnosis of the disease.
During the course of the disease, small skin rashes may occur when pressed on, called purpura. In addition to purpura, bleeding may occur in the mouth, gums and nose. The cause of bleeding is due to the insufficient number of platelets and their inability to fully function.
When the blood taken from these patients is examined with the help of a microscope, large and irregular platelet cells can be seen. Platelets, which are normally the smallest cells in the bloodstream, are almost as big as red blood cells in this disease. This results in the detection of MPV height.
In order to ensure bleeding control in this disease, if the physician deems it appropriate, drugs preventing the melting of clots formed can be used.
Wiskott-Aldrich syndrome
This disease, which passes over the X chromosome and where the immune system is insufficient, is characterized by the reduction of the size and decrease of the number of platelets in addition to red, itchy and rashed skin lesions (eczema). In these patients, diseases classified as autoimmune and various malignant diseases can be added to the discomfort table. The most common malignant disease in Wiskott-Aldrich patients is lymphoma.
In these patients, the frequency of meningitis, middle ear infections, sinusitis and lung infections increases due to the abnormality in defense cell functions. These infections tend to occur repeatedly, and can sometimes be life-threatening.
The life span of platelets has been halved in individuals with Wiskott-Aldrich disease compared to normal individuals. There is a disorder in the replacement of platelets with a short life.
Diagnostic criteria for this disease include the number of platelets below 100 thousand per cubic millimeter and their MPV Mean platelet volume being less than 7.5 femtoliters. A small number of small platelets cause the MPV measured in these patients to be detected lower than the lower limit of 7-7.5 femtoliters.
In Wiskott-Aldrich patients, an increase in the number and MPV Mean platelet volume may occur after removal of the spleen, but these parameters related to platelets are not expected to reach normal values.
Aplastic anemia
Aplastic anemia is a disease that occurs due to a decrease in stem cells that are in the bone marrow and responsible for the production of cells in the bloodstream. The cause of the error may be radiation, drugs, various chemicals or viral diseases, or the underlying cause may not be detected in many patients.
In this disease, in which the bone marrow is replaced by adipose tissue, symptoms such as weakness, fatigue, and pale skin appear pale instead of red due to the inability to produce red blood cells. The decrease in the production of defense cells can prepare the ground for severe infectious diseases.
Due to the decrease in the production of platelet cells, bleeding occurs in the skin and mucous membranes. Even caution should be exercised as these bleeding can be encountered as the first finding of the disease. In patients with aplastic anemia, the number of platelets is reduced, but their appearance and function are normal. The low number of platelets can cause MPV to be detected lower than the normal limit value.
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