Role of immature platelet fraction in etiological diagnosis of thrombocytopenia

Objectives: Immature platelet fraction (IPF) is a newer automated parameter that measures the ratio of reticulated platelets to a total number of platelets. A measure of reticulated platelets determines the rate of thrombopoiesis which can help in differential diagnosis of thrombocytopenia. The study aims to evaluate the relationship between IPF and causes of thrombocytopenia and establish its clinical utility. Materials and Methods: The study was a prospective observational study conducted for 9 months. A total of 70 cases with an equal number of healthy age-matched controls were included in the study. Based on the pathogenesis of thrombocytopenia, the cases were grouped into platelet hypoproduction, hyperdestruction, and megaloblastic anemia. The association between IPF values among control and different case groups was evaluated. Statistical analysis: Assuming a 95% confidence level, the sample size calculated is 61 subjects. Based on the etiopathogenesis of thrombocytopenia, cases were categorized into three groups. Qualitative variables were compared using the Chi-square test/Fisher’s exact test. Quantitative variables were compared using unpaired t -test/Mann–Whitney test. P < 0.05 was considered significant at a 95% confidence level. Results: The reference range of IPF among healthy controls was estimated to be 0.6–6.8%. The mean IPF was significantly higher in the hyperdestructive group (10.6%) as compared to the hypoproductive group (3.6%). The optimal cutoff value of IPF for differentiating hyperdestruction causes from hypoproduction causes was 8.20% with a sensitivity of 75% and specificity of 87.5%. Conclusions: IPF can be used as an initial tool in the diagnostic evaluation of thrombocytopenia.