ANISOCITOSIS CAUSAS PDF

The term anisocytosis indicates the degree of variation in the size of red cells observed on the microscope. Together, the two parameters RDW and MCV may help in the differential diagnosis of various diseases, particularly certain types of anemia. In addition it was also determined the reference values in relation to sex and age. Moreover, to verify the possible relation between the RDW parameters and MCV it was performed the statistical test of Pearson correlation.

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Platelet indices in dogs with thrombocytopenia and dogs with normal platelet counts. It is well known that thrombocytopenia is the most commonly acquired haemostatic disorder in dogs and can be potentially life-threatening. Two groups of dogs were established, those with thrombocytopenia 45 and those with normal platelet counts Mean values of PDW and P-LCR indices in thrombocytopenic animals were significantly higher than the mean values of animals with normal platelet counts.

There was no significant difference in any of the indices in either group of thrombocytopenic dogs. Macroplatelets were present in the blood smears of thrombocytopenic dogs. Results suggested increased thrombopoiesis and release of different sized platelets. P-LCR is also important in thrombocytopenic dogs, especially when associated to the presence of large platelets in blood smears. Key words: platelets, anisocytosis, blood cell analyzer, platelet distribution width.

A complete blood count CBC is an important tool for assessing animal's clinical status since it provides quantitative and qualitative information on all blood cells Rizzi et al Platelet quantification in peripheral blood is a well-recognised tool in veterinary diagnostics.

Thrombocytopenia is the most commonly acquired hemostatic disorder in dogs and can become potentially life-threatening Grindem et al , Bommer et al Severe thrombocytopenia in dogs is mostly caused by immune-mediated thrombocytopenia; however, low platelet counts are also commonly associated with inflammatory, infectious or neoplastic diseases Bommer et al , Botsch et al Recently, new erythrocyte and platelet count related indices have been provided by hematologic analyzers.

However, despite practical applications of red blood cell RBC indices in dogs, platelet indices are not yet currently used in daily clinical practices to evaluate thrombocytopenia Temizel et al Regardless of reticulocyte counts and bone marrow cytological examinations, regeneration can be evaluated by using RBC and platelet indices Flaiban and Balarin Souza et al demonstrated RBC indices provide important information on anemia in dogs, therefore, platelet indices can provide clinical information on thrombocytopenia's underlying conditions.

MPV can be used to assess response of patients with thrombocytopenia. Considering the larger size of early released platelets, an increased MPV could indicate active thrombopoiesis Northern and Tvedten Human immune-mediated thrombocytopenia characteristically presents an increased MPV, reflecting the release of large immature platelets from hyperplastic megakaryocytes in response to peripheral thrombocytopenia Diquattro et al , Noris et al Moreover, thrombocytopenia associated with a decreased MPV suggests insufficient megakaryocytes or bone marrow failure Topper and Welles Besides its use in thrombocytopenia, increased MPV was reported as an indicator of sepsis in dogs Moritz et al As for P-LCR, this index indicates the percentage of large sized platelets in the blood stream Silveira et al Association of differential blood counts with automated analyser results enables data comparison and error checks, resulting in a more effective quality control.

In addition, automated methods provide previously unreached parameters in manually performed methodologies. In order to avoid repetition of animals in this study, in case the same animal possessed more than one blood count, only blood test results from the first clinical evaluation of these animals were used.

Blood smear morphological evaluations were performed in the area located immediately prior to feathered edge, where there is no overlapping of red blood cells. Table 1. Table 2. Blood count analyses showed 45 dogs Mean values and standard deviations of platelet indices for each group of thrombocytopenic dogs are shown in table 2.

There were no significant differences in MPV values between thrombocytopenic dogs and dogs with platelet counts within normal range. However, there were significant differences in PDW and P-LCR indices where mean values of animals with thrombocytopenia were significantly higher than mean values of animals with normal platelet counts.

Chi-square between results of thrombocytopenic groups showed no significant difference in any of the tested indices. Blood smear analysis of thrombocytopenic dogs showed platelet anisocytosis and macroplatelets in 6 animals There were no platelet aggregates in either group. Microfilariae were found in blood smears of 2 thrombocytopenic dogs. Increased PDW and P-LCR levels suggest increased thrombopoiesis and release of different sized platelets which was only microscopically evidenced by presence of macroplatelets and platelet anisocytosis in blood smear of Reinforcing this hypothesis, certain studies have already described how humans and dogs could respond to thrombocytopenia by increasing megakaryocyte numbers or by producing larger and more biologically active platelets Minter and Ingram , Martin et al Schwartz et al suggested that presumptive primary immune-mediated thrombocytopenia in dogs is characterized by increased MPV levels due to large immature platelets" production during a regenerative process.

However, this was not observed in our study. Similar to this, other studies have observed that a decreased MPV may be associated with early stages of immune-mediated thrombocytopenia and it is believed that this reduction could be caused by presence of small platelets Northern and Tvedten , Topper and Welles These MPV results may suggest a low sensitivity of this index to platelet heterogeneity similar to what occurs in MCV for red blood cells, which requires a large number of erythrocytes with different volumes for this index to increase Souza et al As a result of increased amount of larger platelets during a bone marrow response to thrombocytopenia, an increase in platelet heterogeneity may be observed and, thus, PDW should also increase Bommer et al which is what occurred in the present study.

Bommer et al also concluded that PDW is more sensitive to increased amount of large platelets than MPV, partly because MPV values can be influenced by the simultaneous presence of smaller platelets and cell debris. According to other studies, a high MPV may be a risk marker for activated platelets Park et al During an investigation on behavior of MPV in canine babesiosis, investigators found that the average size of platelets in infected dogs was above normal Kettner et al However, in another study on canine babesiosis, thrombocytopenia was detected in This is similar to what occurred in the present study where thrombocytopenic and non-thrombocytopenic dogs presented similar MPV values.

There was no significant difference between the dogs of thrombocytopenic groups in any tested indices. This suggests the degree of thrombocytopenia can not interfere with behavior of these indices.

However, it is possible that low number of animals in each group contributed to development of this profile. Thrombocytopenic animals showed macroplatelets and platelet anisocytosis in morphological analyses. Large platelets can be observed in peripheral blood when bone marrow is intact and when it is overstimulated to produce platelets Kaito et al , Bommer et al Platelet aggregation was not observed in any of the thrombocytopenia cases, discarding pseudothrombocytopenia by platelet agglutination hypothesis.

Tick infestation and cancer were the main clinical data reported in animals with thrombocytopenia. Low platelet counts are believed to be commonly associated with inflammatory, infectious or neoplastic diseases Bommer et al , Botsch et al which are in accordance with results of our study.

Smith et al observed that PDW increased in dogs with hemangiosarcoma compared to control dogs. Carcinoma, lymphoma and hemangiosarcoma were the most commonly reported cancer in thrombocytopenic animals. P-LCR distribution patterns were in agreement with findings of Babu and Basu who detected significantly increased P-LCR values in human patients with thrombocytopenia.

Various studies have stated that platelet indices, especially MPV and PDW, can provide clinical information on the mechanisms of thrombocytopenia Bowles et al , Kaito et al However, in the present study, we alert the importance of P-LCR index in thrombocytopenic dogs, especially when associated to presence of large platelets in blood smears.

Moreover, it was concluded that P-LCR is important when associated to the presence of large platelets in blood smears, indicating an active thrombopoiesis. Babu E, D Basu. Platelet large cell ratio in the differential diagnosis of abnormal platelet counts. Indian J Pathol Microbiol 47, Platelet distribution width and mean platelet volume in the interpretation of thrombocytopenia in dogs.

J Small Anim Pract 49, Retrospective study of dogs with thrombocytopenia. Vet Rec , Platelet size has diagnostic predictive value in patients with thrombocytopenia.

Clin Lab Haematol 27, Relationships between platelet counts, platelet volumes and reticulated platelets in patients with ITP: Evidence for significant platelet count inaccuracies with conventional instrument methods. Int J Hematol 31, Underlying diseases and clinicopathologic variables of thrombocytopenic dogs with and without platelet-bound antibodies detected by use of a flow cytometric assay: 83 cases J Am Vet Med Assoc , Semina: Ci.

Epidemiologic survey of thrombocytopenia in dogs: a report on cases. Vet Clin Pathol 20, Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Brit J Haematol , Thrombocytopenia in canine babesiosis and its clinical usefulness. J S Afr Vet Assoc 74, The biological significance of platelet volume.

Its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res 32, Rev Bras Hematol Hemoter 30, Minter FM, M Ingram. Platelet volume: density relationships in normal and acutely bled dogs. Brit J Haematol 20, Evaluation of flow cytometric and automated methods for detection of activated platelets in dogs with inflammatory disease. Am J Vet Res 66, Differentiation of dogs with regenerative and non-regenerative anemia on the basis of their red cell distribution width and mean corpuscular volume.

Vet Rec 6, Platelet size distinguishes between inherited macrothrombocytopenias and immune thrombocytopenia. J Thromb Haemost 7, Northern J, HW Tvedten.

Diagnosis of microthrombocytosis and immune-mediated thrombocytopenia in dogs with thrombocytopenia: 68 cases Mean platelet volume as an indicator of platelet activation: methodological issues.

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Platelet indices in dogs with thrombocytopenia and dogs with normal platelet counts. It is well known that thrombocytopenia is the most commonly acquired haemostatic disorder in dogs and can be potentially life-threatening. Two groups of dogs were established, those with thrombocytopenia 45 and those with normal platelet counts Mean values of PDW and P-LCR indices in thrombocytopenic animals were significantly higher than the mean values of animals with normal platelet counts.

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