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Mean platelet volume and platelet distribution width are useful in the differential diagnosis of aplastic anemia and idiopathic thrombocytopenic purpura

We read with interest the article by Farias and colleagues on the definition of reference ranges for the platelet distribution width (PDW): a local need (1). In this article, the authors stated that determination of a local reference interval is important for clinicians to appropriately interprete test results and implement appropriate intervention. Reference values are required for all tests in the clinical laboratory for decision-making processes, such as a medical diagnosis, therapeutic management or physiologic assessment (2). We also studied mean platelet volume (MPV) and PDW in 2147 healthy subjects (male: 1335, female: 812). Complete blood cell counts were performed using the Sysmex XE-2100 automated cell counter (Sysmex, Kobe, Japan). To understand the clinical significance of MPV and PDW, we measured MPV and PDW from 136 aplastic anemia (AA) and 87 idiopathic thrombocytopenic purpura (ITP) patients. Although the mean MPV and PDW in both AA and ITP patients were within the reference intervals, there were significant differences in MPVs and PDWs between patients with AA and with ITP (Table 1). MPV and PDW are the two platelet indices measured by automated cell analyzers. They are similar to mean corpuscular volume (MCV) and red cell distribution width (RDW) of erythrocytes, but they are less frequently used by clinicians because they are less familiar with these parameters. The two methods of measuring MPV are electrical impedance and light scatter measurement. PDW may be defined as either the distribution width at 20% frequency level (3) or calculated as the standard deviation of platelet volume divided by MPV =100 (4). The units for each are different;