Comparison Of Red Cell Indices And Coagulation Profile In Thrombocytopenia Patients

Abstract

Background: Thrombocytopenia is a common blood disorder that is characterized by a decrease in the number of platelets. In addition to this fall, patients tend to acquire red blood cell index variations and disruptions of their coagulation pattern. The changes are capable of affecting bleeding risk, severity of diseases, and clinical decision-making. But, there is not much local data telling about the variations of such parameters in different grades of thrombocytopenia of the Pakistani population.

Objective: To compare the red cell indices and coagulation parameters in patients with thrombocytopenia and to find out the relationship between change and the degree of platelet reduction.

Methodology: This cross-sectional research involved 100 patients who were diagnosed with  thrombocytopenia and were selected in a number of diagnostic laboratories in Lahore. The sample was homogenous (52% men and 48% women). Measures were made of red cell indices (MCV, MCH, MCHC) and of coagulation (PT, aPTT, INR, fibrinogen, D-dimer). Patients were clustered as per the level of platelet severity, and non-normal data distribution was observed, which necessitated the use of Kruskal-Wallis test.

Results: Red blood cell indices and coagulation parameters exhibited a notable varying result according to groups of thrombocytopenia degrees of severity ( p < 0.001). Severe thrombocytopenic patients reported reduced MCV, MCH, and MCHC values, which were of a hypochromic and marginally microcytic nature. There was marked abnormality of coagulation markers, increased PT and aPTT, increased INR and D-dimer and significantly decreased fibrinogen levels. The trend of increased D-dimer and low fibrinogen was a good indication of continuing coagulopathy of consumption in the worst case scenarios.

Conclusion: The research points at the fact that the red blood cell indices and coagulation parameters decline proportionally to the decrease in the number of platelets. Severe thrombocytopenia can thus hardly exist on its own and most commonly indicates more hematological or inflammatory malfunction. These results support the importance of comprehensive hematological and coagulation examination of every patient with thrombocytopenia that is presented with the aim of diagnosing, properly monitored, and treated.