“Development and Internal Validation of a Clinical Prediction Model for the Diagnosis of Immune Thrombocytopenia”: Reply

Drs Beyan and Beyan raised concerns about the use of the mean platelet volume (MPV) as one of the variables in a novel clinical prediction model for the diagnosis of immune thrombocytopenia. Their concerns stemmed from the lack of standardization of the MPV and variability with differing anticoagulants, blood analyzers, and time from sample collection. We agree that MPV is an imperfect test; however, it has been shown to be helpful as a global measure of platelet size, comparable with the immature platelet fraction [ [1] Bodrova V.V. Shustova O.N. Khaspekova S.G. Mazurov A.V. Platelet reticulated forms, size indexes and functional activity. Interactions in healthy volunteers. Platelets. 2022; 33: 398-403 Crossref PubMed Scopus (8) Google Scholar ]. In previous studies, a high MPV in the setting of thrombocytopenia has been associated with immune-mediated platelet destruction and hereditary forms of thrombocytopenia [ [2] Noris P. Klersy C. Gresele P. Giona F. Giordano P. Minuz P. Loffredo G. Pecci A. Melazzini F. Civaschi E. Mezzasoma A. Piedimonte M. Semeraro F. Veneri D. Menna F. Ciardelli L. Balduini C.L. Italian Gruppo di Studio delle PiastrinePlatelet size for distinguishing between inherited thrombocytopenias and immune thrombocytopenia: a multicentric, real life study. Br J Haematol. 2013; 162: 112-119 Crossref PubMed Scopus (79) Google Scholar , [3] Norrasethada L. Khumpoo W. Rattarittamrong E. Rattanathammethee T. Chai-Adisaksopha C. Tantiworawit A. The use of mean platelet volume for distinguishing the causes of thrombocytopenia in adult patients. Hematol Rep. 2019; 11: 7732 Crossref PubMed Scopus (11) Google Scholar ].