Korean J Lab Med.  2007 Feb;27(1):7-12. 10.3343/kjlm.2007.27.1.7.

Comparison of an Immature Platelet Fraction and Reticulated Platelet in Liver Cirrhosis

• Kim HR
• Park BR
• Lee MK
• Park AJ
• Ahn JY

• KMID: 1121652
• DOI: http://doi.org/10.3343/kjlm.2007.27.1.7

Abstract

BACKGROUND: The main causes of thrombocytopenia in cirrhosis are thought to be platelet destruction and the reduction of thrombopoietin (TPO) expression in the liver. Immature platelet fraction (IPF) has been measured by a fully automated analyzer (Sysmex XE-2100, Japan) as reticulated platelet (RP), which is reflected with thrombopoiesis in bone marrow. In this study, we tried to compare the percentage of IPF (IPF) with that of RP (RP) in patients with liver cirrhosis (LC) and controls. METHODS: We compared IPF to RP in 72 liver cirrhosis patients and 30 healthy normal controls. RP was stained with acridine orange, followed by FC500 (Beckman Coulter, USA) analysis and the IPF was identified by flow cytometry with the use of a nucleic acid specific dye in the reticulocyte channel on the Sysmex XE-2100 (TOA Medical Electronics Co., Ltd., Japan). RESULTS: IPF value in the healthy control was 2.2% (1.7-5.2). RP and IPF were significantly higher in the patients with liver cirrhosis (P<0.05). IPF appeared to be correlated with RP (y=0.19x+3.35, r=0.34, P<0.05). In ROC for diagnosis of LC, IPF was significantly more useful than RP. CONCLUSIONS: This results show that a rapid, inexpensive automated method for measuring the IPF is feasible and should become a standard parameter in evaluating reticulated platelets.

Keyword

Reticulated platelet; Immature platelet fraction; Sysmex XE-2100; Liver cirrhosis

MeSH Terms

Aged
Female
Humans
Liver Cirrhosis/*complications
Male
Middle Aged
Platelet Count/*methods
Stem Cells/*cytology
Thrombocytopenia/*diagnosis/etiology

Figure

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  Fig. 1. Fluorescence histogram of reticulated platelet (RP) from a normal control (A, RP 1.02%) and a patient with LC (B, RP 18.38%). Abbreviations: AO, acridine orange; LC, liver cirrhosis.

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  Fig. 2. Optical platelet scattergrams from healthy individual with a normal IPF and a patient with a high IPF. Mature platelets appear as blue dots, green dots represent the IPF with increased cell volume and higher fluorescence intensity compared to mature platelets.

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  Fig. 3. Immature platelet fraction (IPF) and platelet counts of patients with LC. The dotted line represents the cut-off value of IPF (2.4%).

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  Fig. 4. Immature platelet fraction (IPF) and platelet counts of controls. The dotted line represents the cut-off value of IPF (2.4%).

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  Fig. 5. Method comparison in 102 samples between RP and IPF.

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  Fig. 6. Receiver operating characteristic curve of the RP and IPF on liver cirrhosis. Abbreviations: IPF, immature platelet fraction; LC, liver cirrhosis.

Reference

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