Mean platelet volume explained

Mean platelet volume
Purpose:	can be used to make inferences about platelet production in bone marrow or platelet destruction problems

Mean platelet volume (MPV) is a machine-calculated measurement of the average size of platelets found in blood and is typically included in blood tests as part of the CBC. Since the average platelet size is larger when the body is producing increased numbers of platelets, the MPV test results can be used to make inferences about platelet production in bone marrow or platelet destruction problems.^[1]

An increased mean platelet volume (MPV) increases the risk to suffer a heart disease ^[2]

MPV may be higher when there is destruction of platelets. This may be seen in immune thrombocytopenic purpura (ITP), myeloproliferative diseases and Bernard–Soulier syndrome. It may also be related to pre-eclampsia and recovery from transient hypoplasia.^[3]

Abnormally low MPV values may correlate with thrombocytopenia when it is due to impaired production of megakaryocytes in the bone marrow, such as in aplastic anemia. A low MPV may indicate inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis.^[4] A high MPV is also a bad prognostic marker in patients with sepsis or septic shock.^{[5] [6]} In addition, low MPV may correlate with abnormally small platelet size, sometimes a symptom of a spectrum referred to as Wiskott–Aldrich syndrome (WAS),^[7] caused by a genetic mutation of the WAS gene.

Sample for MPV testing is obtained in a Lavender-Top EDTA tube. A typical range of platelet volumes is 7.2 - 11.7 fL^[8] (femtolitre), equivalent to spheres 2.65 to 2.9 μm in diameter.

Conditions associated with altered MPV

Decreased MPV

• Cytotoxic chemotherapy
• Hypersplenism
• Reactive thrombocytosis
• Iron-deficiency anemia
• Gilbert's syndrome
• Acquired Immunodeficiency Syndrome (AIDS)
• Wiskott–Aldrich syndrome
• X linked thrombocytopenia
• Crohn's disease
• Ulcerative colitis
• Aplastic anemia
• Megaloblastic anemia^[9]

Increased MPV

• Immune thrombocytopenia
• Disseminated intravascular coagulation
• Myeloproliferative disorders
• Administration of erythropoietin / thrombopoietin
• Recovery from transient hypoplasia
• Gray platelet syndrome
• GATA-1 mutation
• vWD Type 2B
• Platelet Type vWD
• Paris-Trousseau syndrome^[10]
• Mediterranean macrothrombocytopenia
• Bernard–Soulier syndrome^[11]
• MYH9-related disorders
• 21q11 deletion syndrome
• Chronic myelogenous leukemia
• Post-splenectomy
• Vasculitis
• Diabetes mellitus
• Pre-eclampsia
• Chronic kidney disease
• Respiratory diseases
• Thrombocytopenia secondary to sepsis
• Hyperthyroidism
• Hypothyroidism
• Myocardial infarction
• Artificial heart valves
• Massive hemorrhage

Inherited thrombocytopenia with normal MPV

• ATRUS Syndrome
• Thrombocytopenia 2 (THC2)
• Congenital amegakaryocytic thrombocytopenia
• TAR syndrome
• Familial platelet disorder with predisposition to AML

Further reading

• Web site: Davis PD, Nabili SN . Shiel Jr WC . 27 August 2020 . What Is Thrombocytopenia (Low Platelet Count)? . Medicinenet.com .
• Slavka G, Perkmann T, Haslacher H, Greisenegger S, Marsik C, Wagner OF, Endler G . Mean platelet volume may represent a predictive parameter for overall vascular mortality and ischemic heart disease . Arteriosclerosis, Thrombosis, and Vascular Biology . 31 . 5 . 1215–8 . May 2011 . 21330610 . 10.1161/ATVBAHA.110.221788 . free .
• Bessman JD, Gilmer PR, Gardner FH . Use of mean platelet volume improves detection of platelet disorders . Blood Cells . 11 . 1 . 127–35 . 1985 . 4074887 .

Notes and References

1. Web site: Complete Blood Count (CBC) . Testing.com .
2. Mean Platelet Volume May Represent a Predictive Parameter for Overall Vascular Mortality and Ischemic Heart Disease . Arteriosclerosis, Thrombosis, and Vascular Biology . February 2012 . 10.1161/ATVBAHA.110.221788 . Slavka . Georg . Perkmann . Thomas . Haslacher . Helmuth . Greisenegger . Stefan . Marsik . Claudia . Wagner . Oswald F. . Endler . Georg . 31 . 5 . 1215–1218 . 21330610 . 85367 . free .
3. Lippi G, Filippozzi L, Salvagno GL, Montagnana M, Franchini M, Guidi GC, Targher G . Increased mean platelet volume in patients with acute coronary syndromes . Archives of Pathology & Laboratory Medicine . 133 . 9 . 1441–3 . September 2009 . 19722752 . 10.5858/133.9.1441 .
4. Liu S, Ren J, Han G, Wang G, Gu G, Xia Q, Li J . Mean platelet volume: a controversial marker of disease activity in Crohn's disease . European Journal of Medical Research . 17 . 27 . October 2012 . 1 . 23058104 . 3519557 . 10.1186/2047-783x-17-27 . free .
5. Mangalesh S, Dudani S, Malik A . Platelet Indices and Their Kinetics Predict Mortality in Patients of Sepsis . Indian Journal of Hematology & Blood Transfusion . 600–608 . March 2021 . 37 . 4 . 33776267 . 7988247 . 10.1007/s12288-021-01411-2 .
6. Gao Y, Li Y, Yu X, Guo S, Ji X, Sun T, Lan C, Lavergne V, Ghannoum M, Li L . 6 . The impact of various platelet indices as prognostic markers of septic shock . PLOS ONE . 9 . 8 . e103761 . 2014-08-13 . 25118886 . 4131909 . 10.1371/journal.pone.0103761 . 2014PLoSO...9j3761G . Cordula M. . Stover . free .
7. Web site: Wiskott-Aldrich Syndrome . Immune Deficiency Foundation . 2019-03-03.
8. Demirin H, Ozhan H, Ucgun T, Celer A, Bulur S, Cil H, Gunes C, Yildirim HA . May 28, 2011 . Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study . 2024-05-25 . Thrombosis Research. 128 . 4 . 358–360 . 10.1016/j.thromres.2011.05.007 . 21620440 .
9. Book: Clinical Laboratory Medicine. McClatchey KD . 2002. Lippincott Williams & Wilkins. 9780683307511. en.
10. Web site: Paris-Trousseau syndrome . MrLabTest . 2022-05-10.
11. Web site: 7 August 2020 . Geil GD . Yaish HM . Bernard-Soulier Syndrome Workup: Approach Considerations. emedicine.staging.medscape.com. en. 2018-02-22.