Korean J Hematol.  2000 Feb;35(1):7-12.

The Laboratory Findings and the Usefulness of Routine Bone Marrow Examination in Idiopathic Thrombocytopenic Purpura

• Won DI
• Kim HM
• Shim YH
• Yoon KJ

Abstract

BACKGROUND: The utility of bone marow examination (BME) in suspected idiopathic thrombocytopenic purpura (ITP) is an unresolved issue. We have assessed the laboratory findings and the usefulness of routine of BME in children and adults with ITP.
METHODS
Data were collected from hospital medical records and laboratory results of 27 children and 36 adults who had undergone BME for investigation of isolated thrombocytopenia between 1996 and 1999.
RESULTS
Fifty-nine (94%) of the 63 patients had normal or increased number of megakaryocytes on BME. Fifty-six of them were diagnosed as ITP. One patient (4%) in children and 3 patients (8%) of adults had decreased number of megakaryocytes suggestive of other disorders. In ITP, platelet associated immunoglobulin and reticulated platelet had low sensitivities, 23% and 38% respectively. Mean platelet volume (MPV) waslower than normal control group (P<0.001), but higher than aplastic anemia group (P= 0.025). There was no significant difference in platelet distribution width (PDW) between ITP group and aplastic anemia group. Platelet count and MPV were positively correlated (r=0.606, P<0.001).
CONCLUSION
The sensitivities of laboratory tests with peripheral blood for ITP were generally low. However, in childhood and adult patients with suspected ITP the routine performance of BME may be able to be decreased provided that BME should be performed only when the possibility of other disorders is high through a thorough clinical history, physical examination and laboratory findings of peripheral blood.

Keyword

Idiopathic thrombocytopenic purpura; Bone marrow examination; Platelet count

MeSH Terms

Adult
Anemia, Aplastic
Blood Platelets
Bone Marrow Examination*
Bone Marrow*
Child
Humans
Immunoglobulins
Mean Platelet Volume
Medical Records
Megakaryocytes
Physical Examination
Platelet Count
Purpura, Thrombocytopenic, Idiopathic*
Thrombocytopenia
Immunoglobulins