What is MPV?
The main task of thrombocytes (blood platelets) that are produced in the bone marrow and enter the bloodstream is to stop the bleeding and lead to the formation of clots by closing the damaged area when there is an injury on the vessel surface. The half-life of platelets is about 4 days, compared to the 120-day lifespan of red blood cells. The vast majority of thrombocytes produced in the bone marrow are released into the bloodstream to fulfill their functions, while some are stored in the spleen.
When damage occurs on the surface of the vein, blood vessels contract to prevent the blood from escaping out of the vein, platelets gather at the injury site and form a plug. Later, coagulation occurs in that area, and time is gained for repair by closing the damaged area.
Platelets generally have surface properties that allow them to adhere to the environment they are in, but as long as there is no damage to the vessel wall, they move through the blood circulation without sticking.
Although the number of platelets does not vary depending on age, it is considered normal to determine the average number as 150-400 thousand platelets per cubic millimeter. With the developing blood count devices, the mean platelet volume (volume) can be calculated in addition to the platelet count.
Mean thrombocyte volume (MPV), one of the most commonly used parameters for the detection of platelet-related disorders, is used to evaluate the size of platelets and provides an idea about the production of thrombocytes in the bone marrow. It can be a guide to the underlying cause of the change in MPV value due to the larger size of newly produced platelets.
What are the conditions that may cause a change in MPV value?
The unit of MPV value is femtoliter (fl), the normal value range is between 7-11 fl.
High MPV can be detected in smokers, hypertensive patients, diabetics, and obese people.
The increase in thrombocyte size may predispose to the occurrence of diseases related to blood vessels. In cases of stroke caused by an interruption of blood flow to the brain (ischemic), an elevation of MPV can be detected in laboratory tests performed recently following the occurrence of the event.
While there is an increase in the number of thrombocytes in people with diseases such as ulcerative colitis and Crohn’s disease with inflammation in the intestines, the small platelet size has brought the idea that MPV measurements can be used to evaluate the activation of these diseases.
In inflammatory conditions such as rheumatoid arthritis, ankylosing spondyloarthritis, psoriasis, familial Mediterranean fever, and Behçet’s disease, changes in MPV value may occur with the destruction of platelets.
While values higher than the cut-off value (MPV high) are seen in diseases with macrothrombocytopenia (greater than normal and fewer thrombocytes), the low MPV detected may indicate a problem with the production of thrombocytes in the bone marrow.
Immune (idiopathic) thrombocytopenic purpura (ITP)
This discomfort occurs due to acquired (acquired) reasons and is a disorder that occurs due to the defense system’s struggle against its own thrombocytes. It is most common in children. Children between the ages of 2-10 are the age group in which the disease is most frequently encountered.
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 illness caused by viruses in the vast majority of patients. A balance is tried to be established with the increase in production against the increase of destruction, and the degree of thrombocytopenia (low platelet count) varies from patient to patient in line with the effectiveness of this effort.
Due to the larger size of the newly produced platelets, the measured MPV values can be detected above normal.
There is variability with age among the symptoms of the disease. In a child in good health, bleeding and bruises the size of a pinhead are some of the common findings related to the disease. In the adult age group, symptoms sometimes do not occur, and findings that lead to this disease can be detected incidentally as a result of blood count tests performed for other reasons.
During the course of the disease, in addition to minor bleeding and bruises, care should be taken because serious events such as intracranial hemorrhages may occur in cases where the platelet count is excessively low.
Bernard Soulier Syndrome
In Bernard Soulier syndrome, which is a rare disease that shows genetic inheritance due to mutations, extremely large platelets are formed and these platelets are few in number. It is important to examine the presence of individuals with similar diseases in the family in the diagnosis of the disease due to its genetic transmission.
During the course of the disease, small skin rashes that do not fade when pressed on called purpura may occur. In addition to purpura, bleeding may occur in the mouth, gums, and nose. Bleeding is caused by the insufficient number of platelets and their inability to function properly.
When the blood taken from these patients is examined with the help of a microscope, large and irregular thrombocyte cells can be seen. Platelets, which are normally the smallest cells in the bloodstream, are almost the size of red blood cells in this disease. This results in the MPV height being detected.
To control bleeding in this disease, drugs that prevent the dissolution of the formed clots can be used if the physician deems it appropriate.
This disease, which passes through the X chromosome and is the deficiency of the immune system, is characterized by the reduction of the size of the platelets and the decrease in the number in addition to the red, itchy, and rash skin lesions (eczema). Diseases classified as autoimmune and various malignant diseases can be added to the disordered table in these patients. The most common malignant disease in Wiskott-Aldrich patients is lymphoma.
In these patients, the incidence of meningitis, middle ear infections, sinusitis, and lung infections increases due to the abnormality in the functions of defense cells. These infections tend to recur over and over again and can sometimes be severe, life-threatening.
The lifetime of platelets is halved in individuals with Wiskott-Aldrich disease compared to normal individuals. There is a defect in the replacement of thrombocytes with a short life span.
Among the diagnostic criteria for this disease, the platelet count is less than 100 thousand per cubic millimeter and their average volume is less than 7.5 femtoliters. The fewer and smaller platelets cause the MPV value 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 volume of platelets may occur after removal of the spleen, but these parameters related to platelets are not expected to reach normal values.
Aplastic anemia is a disease caused by a decrease in stem cells in the bone marrow that are responsible for the production of cells in the bloodstream. The cause of the error may be radiation, drugs, various chemicals, or viral diseases, and in many patients, the underlying cause may not be determined.
In this disease, where the bone marrow is replaced by fat tissue, symptoms such as fatigue, fatigue, and pale skin instead of red may occur due to the inability to produce red blood cells. The decrease in the production of defense cells may pave the way for severe infectious diseases.
It can be determined that bleeding occurs in the skin and mucous membranes due to the decrease in the production of platelet cells. In fact, care should be taken as this bleeding may be encountered as the first finding of the disease. In patients with aplastic anemia, the number of platelets is decreased, but their external appearance and functions are normal. The low number of platelets may cause the MPV value to be detected lower than the normal limit value.
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