Hypersplenic Thrombocytopenia Differentiated from Increased Peripheral Destruction by Platelet Volume

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Abstract
Platelet volume distribution was examined in 16 patients with hepatosplenomegaly and platelet counts of 45,000 to 90,000/mm, 12 patients with autoimmune thrombocytopenia and randomly matched platelet counts and 20 normal subjects. Five platelet volume variables of increasing platelet size were defined from the averages of 20 normal curves. Patients with hypersplenism had decreased volume values of 78-87% (mean, 83%) of the average normal population (P < 0.001). Patients with autoimmune thrombocytopenic purpura had values significantly greater than normal by 124-149% (mean, 134%) (P < 0.001). Patients with autoimmune thrombocytopenic purpura, when compared with hypersplenic patients, had significantly greater platelet volume values ranging from 154-174% (mean, 161%), P < 0.001. Patients with hepatosplenomegaly have smaller platelets in their peripheral blood and a platelet volume distribution that can be distinguished easily from patients with autoimmune thrombocytopenic purpura, despite comparable platelet counts.