Journal
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume 101, Issue 4, Pages 369-375Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s12185-015-1741-0
Keywords
Immune thrombocytopenia; Reticulated platelets; Differential diagnosis; Paroxysmal nocturnal hemoglobinuria; Thrombopoietin
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Funding
- Ministry of Education, Culture, Sports, Science and Technology in Japan
- Ministry of Health, Labor and Welfare in Japan
- Grants-in-Aid for Scientific Research [26461403, 15K09454] Funding Source: KAKEN
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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.
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