Mean platelet volume a key or obstacle in clinical affairs.

Dear Editor,

Mean platelet volume (MPV) is a parameter generated by full blood count analyzers as part of the routine complete blood count (CBC) test cycle. MPV correlates with platelet function and activation.[1] It ranges from 7.4 to 10.4 fl, which did not differ in age groups or different sex—male or female.[2] MPV changes in different disease has been studied by many clinical reports that was unrelated to blood fields such as varicocele, stroke, and coronary artery disease.[345] Sometimes MPV was used for showing improvement or severity of a diseases such as rheumatologic disease that MPV is lower as compared to healthy control group and increases after treatment; in healthy persons it was 8.51 ± 0.75 fl; while in ankylosing spondylitis, MPV was 7.37 ± 1.09; and 7.10 ± 0.93 flin rheumatoid arthritis patients.[1] Stroke is another disease that may be associated with increased MPV, the wide range area of affection and large vessel occlusion are related to MPV that may reach as high as 8.20 fl.[4] Some studies have gone beyond and found that MPV at a cutoff point of 7.3 fland higher can show severity of coronary artery disease.[5] As compared to other laboratory tests like as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) that increase in both inflammation or infection, MPV is low during of infections like as respiratory syncytial virus (RSV)-affected children that was lower in affected compared to non-affected and the authors considered the level lower than 8.9 flas an indicator of RSV with sensitivity of 79% and specificity of 41%.[6] MPV may have a positive correlation with varicocele grade or spermatic cord diameter that was not known to be infective or inflammatory disease.[3] All these studies show that MPV as a clinical marker is an unreliable test with no acceptable sensitivity or specificity which can show contradicting responses in different diseases that gave fluctuating results in acceptable range based on laboratory references. All these broad uses of MPV cannot be known as a priority of MPV to other tests like as ESR and CRP that some authors tried to put them down as compared to MPV.[1] All these show that many factors have an effect on MPV and justify all in a critical patient who is involved with most of these hazardous complications is impossible. In addition there is not a defined value with high sensitivity or specificity beyond the traditional laboratory reference. In summary, MPV in clinical usage may be an attractive topic for authors and journals, but it engages the time and money of researchers unless its validity improves in clinical practice by bias omission and increases its reliability. I hope studies about MPV changes in different diseases be a solution not an obstacle to diseases management. It seems MPV is like a sun that will dawn soon and go down sooner without giving enough pleasure and warmth to us.