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PDW, or platelet anisocytosis, is a parameter that is tested when performing a blood count. On the blood test result, it is marked with PDW (derived from the English words Platelet Distribution Width). This parameter allows you to determine whether the platelets are of the correct size and, therefore, are able to perform specific functions in the body. In combination with other parameters assessed in the blood count, its abnormal result may suggest an impairment of the proper functioning of blood clotting. Does it include PDW morphology?
Thrombocytes (platelets) are small nucleated structures found in the blood. Their main function is to regulate blood clotting towards thrombus formation. They contain appropriate factors which, when the continuity of a blood vessel is broken, prevent it from bleeding out. Platelets they are produced by the bone marrow and live for a maximum of 10 days. The process of making platelets may be disturbed, and this may in turn result in abnormalities in the obtained morphological results.
It is a parameter that determines the size of platelets. Thus, anisocytosis determines the differentiation of these cells. It should be borne in mind that the platelets will not always be of the ideal size, as the production process is multi-stage.
Blood clotting disorders will be manifested by large variations in the volume of blood cells, some will be very large, while others will be very small. Then the PDW indicator shows an incorrect value.
See more: Blood clotting disorders
PDW — norm
The correct value for platelet anisocytosis is in the range of 40-60%. This is the information for us that such a percentage of platelets is non-standard. This type of compartment occurs in healthy people, i.e. those who are not affected by blood clotting disorders. People who have problems with abnormal clot formation have elevated or low PDW values. The normal extent of platelet anisocytosis may of course vary from laboratory to laboratory, and this in turn is influenced by the equipment on which the test was performed or the measurement method used. With the value of anisocytosis obtained from the patient’s blood, there is always information about the correct range of norms.
The reduction in the rate of anisocytosis (low PDW) is of little diagnostic importance. Contrary to the increased PDW index, this also applies to situations in which other parameters turn out to be incorrect.
If the PDW parameter in the test is significantly higher than the norms suggested by the laboratory, you should not panic right away. It does not have to mean an ongoing inflammatory process or a developing disease.
If there is a PDW above the norm, attention should also be paid to other parameters of the blood count, such as: MPV – average blood cell volume, PLT – the number of platelets and P – LCR, i.e. the number of giant blood cells, the volume of which exceeds 12 fl. If the values of these indicators are incorrect, then you should see a doctor for consultation on the test result.
Also read: Blood counts
Elevated PDW in pregnancy
Anisocytosis during pregnancy it is most often caused by iron deficiency anemia. Pregnant women are more at risk because they need more iron to make red blood cells for the growing baby.
If you are pregnant and diagnosed with anisocytosis, your doctor will likely want to do other tests to see if you have anemia. Anemia can be dangerous to the fetus for the following reasons:
- the fetus may not be getting enough oxygen
- premature birth may occur,
- you may feel excessively tired and generally weak.
See also: Anemia in pregnancy
The causes of anisocytosis
Anisocytosis it is most often the result of another medical condition, known as anemia. In anemia, red blood cells are unable to supply enough oxygen to the body’s tissues. There may not be enough red blood cells, the cells may be irregular in shape, or they may not have enough of an important compound called hemoglobin.
There are several different types of anemia that can lead to different sizes of red blood cells, including:
- iron deficiency anemia – This is the most common form of anemia. It occurs when the body does not have enough iron, incl. due to blood loss or dietary deficiency. Usually causes microcytic anisocytosis,
- Sickle Cell Disease: This is a congenital anemia most common among people in Africa. It is characterized by the sickle shape of red blood cells,
- Thalassemia: This is an inherited blood disorder where the body produces abnormal hemoglobin levels. Usually causes microcytic anisocytosis,
- autoimmune hemolytic anemia: this group of disorders occurs when immune system mistakenly destroys red blood cells,
- megaloblastic anemia – occurs as a result of impaired production of red blood cells, their premature destruction in the bone marrow and shortening the survival time of defective erythrocytes to less than 120 days (macrocytic anisocytosis). This is usually caused by a folate or vitamin B12 deficiency. It occurs mainly in women,
- pernicious anemia – This is a type of macrocytic anemia caused by the body’s inability to absorb vitamin B12. Pernicious anemia is an autoimmune disorder.
Other disorders that can cause anisocytosis include:
- myelodysplastic syndrome,
- liver disease
- thyroid disorders.
In addition, some drugs used to treat cancer, known as cytotoxic chemotherapeutic drugs, can cause anisocytosis.
Anisocytosis can also be seen in people with cardiovascular disease and certain cancers.
Also, check what to eat to avoid anemia: What to eat to increase iron levels
Diagnosing anisocytosis
Anisocytosis is usually diagnosed during taking a blood smear . During this test, a lab worker spreads a thin layer of blood over a microscope slide. Blood is stained to differentiate cells and then viewed under a microscope. This way, the laboratory diagnostician will be able to see the size and shape of the red blood cells.
If the results show that this is anisocytosis, your doctor will probably want to do additional tests. In addition, it will collect from you a medical history in your immediate family and yours. Remember to inform your doctor about possible symptoms and if you are currently taking any medications. Your doctor may also ask you questions about your diet. Other tests your doctor may ask you to do:
- complete blood count,
- iron levels
- ferritin level
- vitamin B12 level,
- folic acid level.
Treatment of anisocytosis withthe cause of the disease. For example, anisocytosis caused by anemia associated with a diet low in vitamin B12, folate, or iron will likely be treated by taking supplements and increasing the amount of these vitamins in the diet.
People with other types of anemia, such as sickle cell anemia or thalassemia, may require a blood transfusion. People with myelodysplastic syndrome may require a bone marrow transplant.
Complications of anisocytosis
Untreated anisocytosis – or the underlying cause of it – can lead to:
- low blood platelet levels
- nervous system damage,
- elevated heart rate.
An abnormal platelet isocytosis does not necessarily mean you have disease. If you are not sure about the correctness of the blood test results, you should consult your doctor who will probably decide to extend the diagnosis with additional tests.
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