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What’s MPV?

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Mean platelet volume (MPV) measures the average size of platelets in the blood and can indicate if the bone marrow is producing them normally. Platelets are involved in blood clotting and stop bleeding when tissue is damaged. An MPV test can detect problems before a platelet count test. High MPV can indicate platelet destruction, chronic myeloid leukemia, or overproduction of thyroid hormones. Low MPV can indicate anemia, chronic renal failure, infection, inflammation, or cancer. Abnormal MPV can increase the risk of thrombosis, stroke, and cardiovascular disease. Aspirin is prescribed for high MPV, but avoided for low MPV.

In medicine, mean platelet volume (MPV) is a measurement that describes the average size of platelets in the blood. Platelets are not true cells, although they are often referred to as such. Like red blood cells, they form in the bone marrow, but are much smaller and are involved in blood clotting, helping to stop bleeding if you are injured. An MPV can be performed as part of a complete blood count (CBC). The importance of the mean platelet volume is that it provides an indicator of whether the bone marrow is producing them normally.

Platelet formation and function

Platelets come from bone marrow cells known as megakaryocytes. These are extremely large, but after a certain point they divide to form platelets, typically releasing more than 1,000 of them into the bloodstream. They flow through blood vessels and when damage occurs to the vessel wall, they stick to it and to each other, forming fibrous structures that seal the break. Platelets clumping work to stop bleeding when tissue, veins, or arteries are cut or suffer other types of physical damage.

The importance of MPVs

A platelet count — often referred to as a Plt — shows whether a person is producing normal amounts of these cellular fragments. If the count is lower or higher than normal, this could be a sign of a blood or bone marrow disorder. An MPV test measures the size of platelets in a blood sample to determine their average; a patient’s MPV can allow a clinician to detect a problem before it shows up in a Plt test. The two tests in combination are used to detect a variety of conditions, many of them serious. A high MPV indicates increased platelet production and a low MPV, decreased production.

A normal measurement for MPV is typically in the range of 5.0 – 15.0 femtoliters: a femtoliter is one quadrillionth of a litre. The measurement, however, usually needs to be evaluated in conjunction with several other factors to determine what is a satisfactory range for a specific patient. Research suggests that the average healthy platelet size can differ in people from different parts of the world. Individuals of Mediterranean descent, for example, are thought to have a higher than average platelet size.

Conditions associated with high MPV

An elevated mean platelet volume is common in patients with some forms of diabetes. When combined with a low Plt result, it indicates a condition leading to platelet destruction. These include immune thrombocytopenia, in which the patient’s immune system destroys platelets; pre-eclampsia, a complication during pregnancy that elevates blood pressure; sepsis, an inflammatory response to an infection; or various hereditary conditions. A high MPV with a normal Plt test result can be a sign of chronic myeloid leukemia, a condition in which too many types of white blood cells are made; o hyperthyroidism, — overproduction of thyroid hormones. Accompanied by a high Plt result, it may indicate a bone marrow disease causing excessive cell production.

Conditions associated with low MPV
In association with a low Plt value, this may indicate a form of anemia, or may result from a therapy involving treatment with drugs that are toxic to cells, for example in chemotherapy used to treat cancer. When combined with a regular Plt, it can indicate chronic renal failure. Accompanied by a high Plt, it can indicate an infection, inflammation or some form of cancer.
Problems caused by abnormal MPV
In addition to indicating underlying conditions that require investigation, an abnormal MPV can itself put a patient at risk. A high MPV means that the blood has an increased tendency to clot, which can increase the risk of thrombosis, stroke and cardiovascular disease. Aspirin is sometimes prescribed for this condition, as it makes it more difficult for platelets to stick together and form clots. A person with a low MPV may bleed more easily; aspirin should be avoided in this case.

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