From the Guidelines
A low Mean Platelet Volume (MPV) in a blood count indicates smaller than average platelets, which may be associated with certain medical conditions, but its clinical significance depends on other blood count parameters, particularly the platelet count itself. This finding is often seen in disorders that affect platelet production, such as bone marrow suppression, certain types of anemia, inflammatory conditions, or immune thrombocytopenia, as well as with certain medications or chemotherapy treatments that affect bone marrow function 1.
Key Considerations
- Low MPV can be a feature of hypersplenism, which is common in patients with advanced cirrhosis, and is linked to portal hypertension, myeloid toxicity, anti-platelet antibody, and/or low levels of thrombopoietin 1.
- The presence of a low platelet count, which can be associated with low MPV, should be integrated into the broader picture of cirrhosis affecting homeostasis, and is not suggested to predict the risk of bleeding in patients with cirrhosis per se 1.
- Rotational thromboelastometry may be superior to routine coagulation laboratory tests in predicting the risk of bleeding during high-risk procedures, including liver transplantation 1.
Management Approach
- Correction of a low platelet count is not recommended before low-risk procedures, and blood products should be used sparingly to avoid side effects, including fluid overload 1.
- Before a high-risk procedure or in the presence of bleeding, platelet transfusion can work synergistically with local haemostatic means, and thrombopoietin receptor agonists like avatrombopag and lusutrombopag should be considered as alternatives 1.
- Treatment should focus on addressing the underlying cause of low MPV, rather than the low MPV itself, and may involve additional testing to determine the cause, such as a complete blood count with differential, bone marrow examination, or tests for inflammatory or autoimmune conditions.
From the Research
Low Mean Platelet Volume (MPV) in Blood Count
A low Mean Platelet Volume (MPV) in a blood count indicates that the average size of platelets in the blood is smaller than normal.
- The MPV is an important parameter in the diagnosis and management of various blood disorders, including thrombocytopenia and thrombocythemia.
- A low MPV can be associated with certain medical conditions, such as iron deficiency anemia, vitamin B12 deficiency, and thrombocytopenia 2.
- Thrombopoietin receptor agonists (TPO-RAs) are a class of drugs that can increase platelet production and have been used to treat thrombocytopenia 3, 4, 5, 6.
- However, the relationship between MPV and TPO-RAs is not well established, and more research is needed to understand the effects of these drugs on platelet size.
Possible Causes of Low MPV
Some possible causes of low MPV include:
- Iron deficiency anemia
- Vitamin B12 deficiency
- Thrombocytopenia
- Bone marrow disorders
- Certain medications, such as chemotherapy drugs
Treatment Options
Treatment options for low MPV depend on the underlying cause of the condition.