From the Guidelines
Elevated Mean Platelet Volume (MPV) is primarily caused by increased platelet production in response to various medical conditions, with myeloproliferative disorders like polycythemia vera being a significant contributor, as evidenced by the presence of qualitative cell defects and a baseline pro-thrombotic state in these conditions 1.
Causes of Elevated MPV
The causes of elevated MPV can be multifactorial, including:
- Inflammatory disorders like rheumatoid arthritis and inflammatory bowel disease
- Cardiovascular diseases such as hypertension and heart failure
- Diabetes mellitus
- Certain infections
- Myeloproliferative disorders like essential thrombocythemia and polycythemia vera
- Lifestyle factors such as smoking, obesity, and high alcohol consumption
- Medications like thrombopoietin receptor agonists (eltrombopag, romiplostim)
- Iron, vitamin B12, or folate deficiencies, which can lead to the production of larger platelets as the bone marrow compensates for the deficiency
Clinical Implications
Elevated MPV indicates that the body is producing newer, larger platelets, often in response to increased platelet destruction or consumption. These larger platelets are typically more reactive and have greater prothrombotic potential, which explains why elevated MPV is associated with increased cardiovascular risk 1. Regular monitoring of MPV alongside other blood parameters is important for patients with chronic conditions that affect platelet production or function.
Key Considerations
In the context of myeloproliferative disorders, the presence of the PIA2 allele of platelet glycoprotein (GP) IIIa has been associated with an increased risk of arterial thrombosis, highlighting the importance of genetic factors in the development of thrombotic complications 1. Additionally, the prevalence of myeloproliferative neoplasms (MPNs) in patients with abdominal vein thrombosis, such as Budd-Chiari syndrome and portal vein thrombosis, underscores the need for careful evaluation and management of these conditions to prevent thrombotic events 1.
From the Research
Causes of Elevated MPV
Elevated Mean Platelet Volume (MPV) has been associated with various conditions, including:
- Cardiovascular diseases 2
- Cerebral stroke 2
- Respiratory diseases 2
- Chronic renal failure 2
- Intestine diseases 2
- Rheumatoid diseases 2
- Diabetes 2
- Various cancers 2
Effects of Antiplatelet Therapy on MPV
Antiplatelet therapy, such as aspirin and clopidogrel, can have a paradoxical effect on MPV, leading to an increase in MPV despite a reduction in platelet count 3. This increase in MPV is not related to the extent of platelet aggregation inhibition by aspirin 3.
Relationship Between MPV and Platelet Count
A significant inverse relationship between MPV and platelet count has been observed, suggesting that larger platelets may be more reactive 3. However, this relationship is not straightforward, and larger MPV does not necessarily imply higher platelet reactivity 3.
Inflammatory Conditions and MPV
MPV has been shown to be a useful predictive and prognostic biomarker of inflammatory conditions, including cardiovascular events 2. Elevated MPV has been observed in various inflammatory conditions, such as rheumatoid arthritis, diabetes, and certain cancers 2.