Diagnostic Use
Platelets are non-nucleated fragments of megakaryocyte cytoplasm, formed chiefly in the bone marrow. The platelet count is part of the FBC and is used to assess bleeding risk, monitor bone marrow function, and diagnose hematologic or inflammatory disorders. A low platelet count (thrombocytopenia), may indicate immune thrombocytopenic purpura (ITP), bone marrow suppression, or viral infections. Thrombocytosis, or a high platelet count may be reactive (e.g. inflammation, iron deficiency) or due to myeloproliferative disorders like essential thrombocythemia. The platelet count can also be used to assess the effects of chemotherapy, antiplatelet drugs, or bone marrow recovery.
Interpretation
Platelets are non-nucleated fragments of megakaryocyte cytoplasm, formed chiefly in the bone marrow. Each megakaryocyte can give rise to as many as 3,000 platelets. Approximately 20-30% of circulating platelets are sequestered in the spleen and the normal life span of a platelet is 8-14 days.
In the laboratory, the platelets are measured by electrical impedance in the Red Cell Channel using Sysmex analysers. Platelets are counted in the 0 – 40 fL range and so giant platelets may not be counted. Very rarely, small red cell fragments can be counted as platelets and falsely elevate the count. If the platelet distribution graph is abnormal or the platelet count is low or falling, then a count can be produced in the PLT-F channel on XN analysers using a specific fluorescent stain.
Causes of a raised platelet count (thrombocytosis):
Infection/Inflammation
Iron deficiency
Aquired Haematologic – Essential thrombocythaemia, CGL, Polycythaemia rubra vera
Blood loss
Malignancy
Redistributional – post splenectomy, hyposplenism
Causes of a lowered platelet count (thrombocytopenia):
Bone marrow suppression/infiltration – Drugs, radiotherapy, leukaemia, aplastic anaemia, MDS, HIV, alcohol
Increased platelet consumption – autoimmune (ITP), drug-induced, neonatal (isoimmune) purpura, DIC, TTP, Heparin, viral/bacterial infection
Redistributional – Splenomegaly
Dilutional – Massive transfusion
Reference Intervals
See Full Blood Count for age and sex related reference intervals.