Asian Hematology Research Journal

Background: Thrombocytopenia is a common haematological abnormality encountered in clinical practice and is associated with a wide spectrum of etiologies ranging from transient infections to chronic systemic disorders. The clinical significance of thrombocytopenia depends not only on platelet count but also on the underlying cause and platelet functional parameters.

Aim: The present study evaluates the clinical and laboratory profile of patients with thrombocytopenia and assesses the association between platelet count, platelet indices, and bleeding manifestations.

Materials and Methods: This hospital-based cross-sectional observational study was conducted in the Department of General Medicine at a tertiary care teaching hospital over a period of 18 months. A total of 110 adult patients with platelet counts less than 100,000/µL were included. Detailed demographic and clinical data were recorded. Laboratory evaluation included complete blood count with platelet indices—mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet large cell ratio (P-LCR). Statistical analysis was carried out using SPSS software. Associations between categorical variables were assessed using the Chi-square test, while the comparison of mean platelet indices between groups was performed using an independent t-test. A p-value <0.05 was considered statistically significant.

Results: The majority of patients were aged 31–45 years with a male predominance (61.8%, p=0.013). Fever was the most common presenting symptom (70.9%, p<0.001), and bleeding manifestations were observed in 34.5% of patients. Dengue fever was the leading cause of thrombocytopenia (35.5%, p<0.001). A statistically significant association was found between bleeding manifestations and severe thrombocytopenia (<20,000/µL), with 85.7% of these patients experiencing bleeding compared to only 15.4% in those with counts >50,000/µL (p<0.001). Furthermore, patients with bleeding had significantly higher MPV (12.1±1.3 vs. 10.7±1.2 fL, p<0.01) and PDW (18.4±2.1% vs. 15.9±2.0%, p<0.01), and lower PCT (0.09±0.03% vs. 0.13±0.04%, p<0.05) compared to those without bleeding.

Conclusion: Thrombocytopenia is predominantly caused by infectious etiologies in tropical regions. The statistical analysis confirms that while severe thrombocytopenia is strongly associated with bleeding risk, platelet indices—specifically MPV, PDW, and PCT—serve as valuable independent adjunctive markers for assessing bleeding risk and understanding underlying mechanisms, aiding in improved clinical evaluation and management.