title: Clinical significance of IPF% or RP% measurement in distinguishing primary immune thrombocytopenia from aplastic thrombocytopenic disorders.
abstract: The diagnosis of primary immune thrombocytopenia (ITP) is based on differential diagnosis. Although the measurement of percentages of reticulated platelets (RP%) by flow cytometry is useful as a supportive diagnostic test, this method is nonetheless a time-consuming, laboratory-based assay. To identify alternative assays that are useful in daily practice, we compared three methods in parallel, IPF% measured by XE-2100 [IPF% (XE), Sysmex Corp.], IPF% measured by new XN-1000 [IPF% (XN)], and RP%. We examined 47 patients with primary ITP, 28 patients with aplastic thrombocytopenia (18 aplastic anemia and 10 chemotherapy-induced thrombocytopenia) and 80 healthy controls. In a selected experiment, we examined 16 patients with paroxysmal nocturnal hemoglobinuria (PNH) to examine the effect of hemolysis. As compared with IPF% (XE), IPF% (XN) showed better within-run reproducibility. The sensitivity and specificity for the diagnosis of ITP were 83.0 and 75.0 % for IPF% (XE), 85.1 and 89.3 % for IPF% (XN), and 93.6 and 89.3 % for RP%, respectively. Examination of PNH patients revealed that hemolysis and/or red blood cell fragments interfered with IPF% (XE) values, but not with IFP % (XN) values. Our results suggest that IPF% measured by XN-1000 may be of comparable value with RP% as a supportive diagnostic test for ITP.
authors.affiliation: Department of Blood Transfusion, Osaka University Hospital, Suita, Osaka, 565-0871, Japan.
authors.forename: Mikiko
authors.initials: M
authors.lastname: Sakuragi
authors.forename: Satoru
authors.initials: S
authors.lastname: Hayashi
authors.forename: Miho
authors.initials: M
authors.lastname: Maruyama
authors.forename: Osamu
authors.initials: O
authors.lastname: Kabutomori
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kiyokawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nagamine
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kato
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kashiwagi
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kanakura
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tomiyama
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D013921:Thrombocytopenia / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D013926:Thrombopoietin / Q000097:blood
chemical_list: D013926:Thrombopoietin