Understanding mean platelet volume (MPV)

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Mean platelet volume (MPV) is a measure of the average size of platelets , a type of blood cell that helps prevent bleeding. MPV is especially important in determining the cause of thrombocytopenia (low platelet count) or thrombocytosis (high platelet count) and can be a useful diagnostic tool even if your platelet count is normal.

Your MPV can also go up or down with certain conditions, such as heart disease, lupus, thyroid disease, and infections .

The purpose of the test

Platelets, also called platelets, are the cells responsible for blood clots, slowing blood loss, preventing infection, and promoting healing. When an injury occurs, platelets collect, clogging the wound and sending hormonal signals through the blood to attract protein clotting factors that help repair the injury .

Platelets are produced in the bone marrow by megakaryocytes, which are large progenitor cells. The platelets themselves, which enter the bloodstream from the bone marrow, are actually parts of megakaryocytes.

Younger platelets are usually larger than older ones. MPV is often considered a reflection of the average age of your platelets.

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How does the MPV test work?

The average platelet count is measured as part of your complete blood count (CBC), a blood test used in health screenings and monitoring of many health conditions.

To obtain the MPV value, your blood is drawn into a purple top tube that contains an anticoagulant, so the blood does not clot and therefore gives an abnormal result for both platelet count and MPV.

Regular MPV

Your CBC includes your total platelet count, as well as your platelet indices , such as MPV and platelet distribution width (PDW), a measure of the variation in your platelet width.

These indices provide detailed information about your platelets, giving a more complete description of what your platelets actually look like. In fact, even if you have a normal platelet count, abnormal readings can alert your healthcare provider to a problem.

Normal ranges

  • Platelets: 150,000 to 450,000 per milliliter
  • MPV: 8.9 to 11.8 fl (femtoliters)
  • PDW: 9.6 to 15.3 l

Labs differ in control ranges, so check your CBC report for the range of your results.

Bruising is usually associated with a platelet count of around 50,000. A platelet count below 20,000 can predispose to life-threatening bleeding .

When MPV is high, the laboratory usually checks it with a blood smear. The technologist will stain a glass slide containing your blood sample and examine it under a microscope to see if the platelets are sticking together or if you really have giant platelets.

Reasons for a high MPV

A high MPV is usually a sign that there are more young platelets circulating in the bloodstream. After bleeding from an injury or a procedure such as major surgery, your body consumes platelets to heal the wounds and stop the bleeding. In response, your bone marrow produces more megakaryocytes, which develop into younger, larger platelets, and your MPV increases.

You may have a high MPV with a low, normal, or high platelet count, and looking at these results together helps make a diagnosis.

A high MPV with the following platelet count may indicate comorbid conditions:

  • A low platelet count along with a high MPV level occurs when platelets are destroyed, usually by antibodies, infections, or toxins. For example , immune thrombocytopenic purpura (ITP) is a platelet deficiency caused by the destruction of platelets with no known cause.
  • A high platelet count along with a high MPV can occur when the bone marrow makes too many platelets, usually due to a genetic mutation or cancer.
  • A normal platelet count along with a high MPV level suggests conditions such as hyperthyroidism or chronic myeloid leukemia (CML), a type of cancer .

High MPV with variable platelet count

Conditions that may be associated with elevated MPV levels and variable platelet counts include:

  • Bernard-Soulier disease (giant platelet syndrome)
  • Medicines that stimulate the bone marrow, such as erythropoietin or thrombopoietin.
  • Diabetes mellitus
  • Platelet genetic abnormalities
  • Heart disease or artificial heart valves
  • Hyperthyroidism
  • Nonalcoholic liver disease
  • Preeclampsia (toxemia of pregnancy) and HELLP syndrome
  • Respiratory diseases
  • Septicemia

Factors Affecting MPV

Factors such as height, hormones, and health risk factors can affect platelet count and volume:

  • People who live at low altitudes (below sea level) may have higher than average platelet counts. Those who live at high altitudes may have a high MPV, which is considered a possible risk factor for heart disease .
  • Smoking, high blood pressure, and high glucose levels (without a diagnosis of diabetes) are associated with high MPV levels in men .
  • Menstruation and oral contraceptives are associated with elevated MPV levels in women.
  • Strenuous exercise is also associated with an increase in platelet count if it is heavy enough to cause tissue damage.

It is important to consider these factors, knowing that the platelet count and MPV can vary.

Causes of low MPV

A low MPV level generally suggests that most of your platelets are older and your bone marrow has decreased platelet production. Also in this case, the total platelet count can help to understand the cause.

A low MPV with the following platelet count may indicate comorbid conditions :

  • A low platelet count along with a low MPV indicates a bone marrow disorder that slows or decreases platelet production, such as aplastic anemia .
  • A high platelet count along with a low MPV often means infection, inflammation, or cancer.
  • A normal platelet count along with a low MPV is common in chronic kidney failure.

Low MPV and variable platelet count

Conditions that may be associated with a low MPV and variable platelet count include:

  • Bone marrow failure
  • Lupus
  • Splenomegaly (an enlarged spleen), which causes platelets to get trapped in the spleen.
  • Medicines that inhibit platelet production, such as chemotherapy.
  • Hypothyroidism
  • iron deficiency anemia
  • HIV / AIDS

Additional tests

MPV is a useful test, but not a diagnostic one. And some conditions, such as cancer, can be associated with a low or high MPV. Your MPV scores are counted along with your other symptoms. For example, you may need a thyroid test if you have symptoms of hyperthyroidism or hypothyroidism.

Similarly, if you have unexplained weight loss or bruising due to high or low MPV, you may need further examination with a bone marrow biopsy, which can identify certain types of cancer and determine if your bone marrow is working. correctly.

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Some research suggests that MPV may be associated with the prediction of conditions such as heart attacks and strokes. Similarly, there may be a link between MPV and certain nutrient deficiencies such as vitamin D and vitamin B12. In general, while certainly good to consider, MPV should be considered in conjunction with your general health and other laboratory findings.

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