Mpv

Mar 21, 2018 Mean platelet volume, or MPV, refers to the medical test reading of the size of the platelets in a blood sample. The platelets are components of our blood responsible for stopping any bleeding by clumping and clotting blood vessel injuries. MPV or Mean Platelet Volume refers to the blood test of the platelets size in a blood sample. The platelets are components of the blood system responsible for halting the bleeding by clotting blood vessel injuries. A complete blood profile, called CBC (Complete Blood Count) is a blood test that examines low MPV counts.

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Do you bruise more easily than others? If so, you may have a problem with your platelets, disk-shaped cell fragments that help stop bleeding. A mean platelet volume (MPV) test can help determine your platelet size and activity. Higher or lower MPV may be a sign of bleeding disorders or bone marrow disease. Read on to learn more about what an MPV blood test can reveal about your health.

Basic video player application for Windows that enables the playback of DVD files inserted in the optical drive. MPV is affected by some cardiovascular factors. Some cardiovascular risk factors such as smoking and hypertension can greatly influence MPV, based on the confounding factors like low-grade inflammation. There is a confirmed correlation between increased MPV and the risk of thrombosis.

What is MPV?

An Overview of MPV

When your platelets are not working properly, you may have an increased risk of bleeding and bruising.

To find out what’s going on, in addition to a standard platelet test that checks the number of platelets in your blood, your doctor may also order a mean platelet volume (MPV) test, which measures the average size of platelets (thrombocytes). If more platelets are being produced in the body, their average size will usually increase as well. This test can offer insight into your overall platelet function and activity.

Platelets are tiny cell fragments that are formed from budding off of very large cells in the bone marrow called megakaryocytes [1].

Once platelets are in the bloodstream, they live for about 8 to 10 days and are then destroyed. Around a third of all platelets are stored in the spleen [1].

The main function of platelets is to prevent excessive bleeding when we are injured. When you cut yourself, for example, platelets stick together to plug the site of injury. Other clotting factors are then recruited to the scene to prevent further bleeding [2].

But platelets are not just the “band-aids” of the circulatory system. Recent studies show that they also contribute to inflammation, defend against microbes, release growth factors to assist in wound healing, and help form new blood vessels [3].

Platelets come in different shapes and sizes. Newly produced platelets are usually larger while older platelets are smaller [4, 5, 6, 3]. Also, when platelets are activated, they change from a disc-shaped cell into a spherical-shaped cell [7].

MPV Blood Test

Since platelets become larger when the body is producing more of them, and vice versa, an MPV test can be used to check for issues with platelet production in the bone marrow or platelet destruction [8, 9].

An MPV test is often included as part of acomplete blood count (CBC) test, which assesses the overall composition of the blood and its individual components, including red blood cells, white blood cells, and platelets [10].

However, an MPV test can’t be used to diagnose anything on its own. Your doctor will interpret the test in conjunction with your medical history and other test results.

MPV Normal Range

The normal MPV range is around 7-12 fL (fL= one femtoliter, a very small unit of blood).

There is some lab-to-lab variability in ranges due to differences in equipment, techniques, and chemicals used.

Low MPV

A low MPV means that platelets are smaller than average. In general, smaller platelets tend to be older, so a low MPV may mean that bone marrow is not producing enough new platelets [11].

However, a low MPV on its own is not informative enough and must be looked at in conjunction with other tests to diagnose platelet-associated conditions.

Causes of Low MPV

Causes shown below are commonly associated with low MPV. Work with your doctor or another health care professional to get an accurate diagnosis.

1. Inflammatory Diseases

Some inflammatory diseases, such as rheumatoid arthritis, lupus, inflammatory bowel disease (IBD), and familial Mediterranean fever have been associated with low MPV. MPV usually increases with anti-inflammatory therapy [3, 12, 13].

2. Impaired Bone Marrow Function

Some conditions which impaired bone marrow function, such as aplastic anemia, are associated with low MPV. New platelets are not produced by the bone marrow, so older, smaller platelets make up a larger proportion of all the platelets in the bloodstream [14, 15].

3. Chemotherapeutics

Drugs that kill cells or reduce their division, such as chemotherapy drugs, can decrease platelet production and MPV [15, 14].

4. Genetic Disorders

Some rare genetic clotting disorders have been associated with lower MPV [16].

Increasing MPV

A low MPV is usually caused by an underlying medical condition. Alternatively, it can be low due to chemotherapy.

Work with your doctor to find out what’s causing low MPV and to treat any underlying conditions. MPV usually returns to normal once the underlying condition has been resolved.

High MPV

A high MPV means that platelets are larger than average. Larger platelets are more reactive. This is sometimes a sign that the body is producing too many platelets [17].

However, a high MPV on its own is not informative enough and must be looked at in conjunction with other tests to diagnose platelet-associated conditions.

Causes of High MPV

Causes shown below are commonly associated with high MPV. Work with your doctor or another health care professional to get an accurate diagnosis.

1. Vitamin D Deficiency

A study with 434 people found that lower blood vitamin D levels were associated with high MPV [18].

2. Obesity and Other Metabolic Disorders

A study of 100 obese and 100 non-obese people suggests that obesity may be associated with significantly higher MPV. The higher the BMI the higher the MPV was in the obese group [19].

Other metabolic disorders that have been associated with higher MPV include high cholesterol, diabetes, and insulin resistance [20, 21, 22].

3. Thyroid Disorders

Both underactive and overactive thyroid (hypo- or hyperthyroidism) have been linked to higher MPV [23, 24].

4. Idiopathic Thrombocytopenic Purpura

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease in which antibodies attack platelets. It’s associated with higher PMV [25]

5. Cancer

Slow-growing blood cancers (myeloproliferative disorders) and various other cancers have been associated with higher MPV [14, 26, 27, 28].

In a meta-analysis of 18 studies and ~3.5k people, MPV was significantly higher in people with malignant tumors than in healthy people and decreased after treatment [29].

Chronic myeloid leukemia (CML) is a rare type of cancer of the blood cells. Platelet production in this disease is abnormal and results in giant platelets. In one study of 58 patients with CML, MPV was higher in people with normal or higher platelet counts.

6. Genetic Disorders

Some inherited genetic disorders can increase MPV. One of the most common such disorders is thalassemia, an inherited red blood cell disorder [14, 30, 31, 32, 33, 34]

7. Smoking

Several studies, each of a couple hundred people, suggest that smokers have higher MPV and that smoking cessation helps decrease it [35, 36, 37].

8. High Altitude

In a study of 401 people with a suddenly reduced heart blood flow (acute coronary syndrome), MPV on average was higher in people living at high altitudes [38].

Health Consequences of a High MPV

Under certain conditions, platelets can be harmful, causing blood clots to form where they are not needed. Sometimes, clots will form inside blood vessels, restricting the flow of blood to tissues. Parts of these clots can also break off and travel through the bloodstream, where they lodge in the lungs, heart, and brain, causing severe damage and even death [39, 40].

A factor in dangerous blood clot formation is platelet size. Research suggests that larger platelets are more active and form more blood clots. Several studies have linked higher mean platelet volume (MPV) to heart attacks and clots in the deep veins [41, 42].

A large study of almost 26k people in Norway found that people with a higher MPV (>or= 9.5 fL) at baseline had a higher risk of blood clots (venous thromboembolism) during the 10-year long follow-up, compared to people who had lower MPV (MPV < 8.5 fL) [43].

In addition, there are two meta-analyses showing an association between heart attacks and higher MPV. However, these studies compared platelet size between people with heart disease and people without [44, 45]. While a causal link between MPV and heart attacks is plausible, large-scale studies are needed to conclude whether a higher baseline MPV is linked to a higher future risk of heart attacks.

Decreasing MPV

Discuss the strategies listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!

1. Address Underlying Conditions

A high MPV is often due to an underlying medical condition. The most important thing is to work with your doctor to find out what’s causing your high MPV and to treat any underlying conditions!

2. Lose Weight

Diabetes and obesity are associated with higher MPV [21, 19].

If you are overweight, implementing a diet and exercise regime that can help you lose weight may also help lower your MPV.

3. Check Vitamin D Levels

Check your vitamin D levels. Vitamin D deficiency can increase MPV [18].

If your vitamin D levels are low, you can [46]:

spend more time outdoors in the sun
eat more fatty fish, like tuna, mackerel, and salmon
Discuss vitamin D supplements with your doctor

4. Stop Smoking

Several studies, each of a couple hundred people, suggest that smokers have higher MPV and that smoking cessation helps decrease it [35, 36, 37].

Last reviewed by Dr. Raj MD on August 13th, 2018.

What is MPV (Mean platelet volume) in blood test ?

It refers to the size of the platelet, which is used to determine the functionality of platelet.

MPV Blood test is a part of the routine complete blood count (CBC). MPV stands for Mean Platelet Volume. MPV is carefully monitored in patients suffering from a condition related to bone marrow and platelet destruction.

Aside from monitoring the volume of the platelet, other blood markers should also be checked, especially the white blood cells and red blood cells. ^{(1, 2)}

MPV Blood Test Range (Normal range)

The normal value of mean platelet volume is expressed in range. The normal range is between 7.2 fL and 11.8 fL in adults. However, reading in between 9.7 fL and 12.8 fL is considered safe too. The normal range varies depending on the laboratory techniques and machines used. ⁽²⁾

Image 1 : An illustration of blood vessels and various compositions of the blood
Photo source : images.wisegeek.comPicture 2 : A microscopic presentation of platelets and red blood cells
Photo Source : www.infoinformations.com

What does it mean when your MPV is high?

Platelet plays a huge role in the blood coagulation process. If the level of platelet is high, it could indicate that you are suffering from acute myocardial infarction. In the case of acute ischemic cardiovascular event, the level of platelet is also checked.

To bring the level of MPV to normal range, a person should quit smoking. Health conditions like hypertension and hyperlipidemia should be managed too or else the patient will be at risk for cardiac complications.^{(2, 3)}

What does low mean platelet volume mean?

If the MPV is lower than the normal range, it means that your platelet count is low. If your body does not have adequate level of platelet, it puts you at risk for bleeding. If you sustain an injury, you will be prone to blood loss due to excessive bleeding because the blood does not have enough clotting factor. Low MPV could indicate many diseases and disorders.

A low MPV is an indicator that the platelet in the blood is lower than normal, which puts you at risk for severe blood loss if you get injured.^{(3, 4,5)}

Reasons for low MPV

Error in collecting blood sample – One of the reasons for low MPV is mistakes in collecting blood samples. Chances are, before the blood is tested it already undergone clotting. This leads to inaccurate result.
Viral Infection – A low platelet count indicates that you are suffering from viral infection such as Dengue fever and AIDS. ⁽⁵⁾
Side effects of medications – Some drugs lowers MPV such as heparin.
Genetic disorder/autoimmune disorder – Patients suffering from genetic conditions have low mean platelet volume. Examples are haemolytic disorder, lupus, leukemia, aplastic anemia, and rheumatoid arthritis.
Over activity of the spleen – A hyperactive spleen can lead to a low mean platelet volume reading.

A very low mean platelet volume is known as thrombocytopenia. Patients suffering from thrombocytopenia are prone to bleeding. It will be extremely difficult for the body to clot the blood during bleeding because of inadequate amount of platelet. ⁽⁶⁾

Please note :

Immature platelet fraction normal range and its uses

What does PDW mean in a blood test?

PDW stands for Platelet Distribution Width. It measures the platelet’s uniformity in size. It is significant in determining the functions of the bone marrow. Ideally, younger platelets are large in size. Smaller platelets have been around for several days. If the number of large platelets is high in a patient with a low platelet count, it is an indicator that the bone marrow is now producing sufficient level of platelets.

Platelet Distribution Width is a part of CBC (Complete Blood Count). The doctor will thoroughly check PDW if the patient is suffering from unexplained bruising and excessive bleeding from small wounds and cuts. It is also checked in patients with several episodes of nose bleeding. Purplish spots and rashes are also the reasons for PDW monitoring.^{(7, 8)}

What to keep in mind?

If the platelet count is low but the mean platelet volume is high, it indicates that there is a destruction in platelet. This is common in patients with immune thrombocytopenia and pre-eclampsia.
If the platelet count is normal but the mean platelet volume is high, it could indicate chronic myeloid leukemia (over production of a specific type of white blood cells). It could also indicate hyperthyroidism (over production of thyroid hormones).
A high MPV and high platelet count indicates that the bone marrow is producing too much platelets. ⁽⁸⁾
A low MPV can be caused by a certain types of drugs. These drugs are toxic to the cells and they should be used in moderation.
Blood clumping is common in people with high mean platelet volume. Since there is excessive production of platelet, there is a tendency that the blood will clump together, which puts the patient at risk for thrombosis, cardiovascular diseases, and stroke. To prevent the blood from clumping, doctors usually prescribe aspirin.
A low mean platelet volume can put you at risk for bleeding because the clotting factor of the blood is impaired. Hence, a person with low mean platelet should completely avoid aspirin. Giving aspirin could further lead to bleeding. ⁽⁹⁾
Mean platelet volume measures how reactive and large the platelets are. If the mean platelet volume is elevated, it means that the platelet is large and more reactive. This could lead to increased platelet turnover, which will put you at risk for myocardial infarction.
Mean platelet volume is used as a prognostic marker, especially in conditions like ischemic bowel disease and stroke. By determining the level of MPV, the doctor can tell if the patient has high or low prognosis.
Cardiovascular factors can greatly affect the level of mean platelet volume. This includes hypertension and excessive smoking. More so, an increased mean platelet volume level can put a patient at risk for thrombosis. It is also linked with cardiovascular disease and cerebrovascular disease.⁽¹⁰⁾

References:

http://healthresearchfunding.org
https://en.wikipedia.org
https://labtestsonline.org
www.doctorshealthpress.com
www.med-health.net
ehealthhall.com
www.thrombocyte.com
www.ncbi.nlm.nih.gov
www.brighthub.com
www.dovemed.com

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