Thalassemia is the most prevalent among all hemoglobinopathies. An estimated 270 million people worldwide are thought to be carriers of various hemoglobinopathies, with 30% of them having β-thalassemia.(1) Thalassemia is a group of inherited hemoglobin disorders characterized by reduced synthesis of one or more of the globin chains leading to imbalanced globin synthesis which is the major factor in determining the severity of the disease in the thalassemia syndromes. Beta-thalassemia results from a defect in beta globulin chain production.(2) It is an autosomal recessive genetic disorder characterized by hemolytic anemia. β- thalassemia is caused by abnormalities of the single β-globin gene that interfere with the synthesis of the globin chains of hemoglobin; this interference can cause total (β0) or partial (β+) disruption of globin chain synthesis.(3) Mean platelet volume (MPV) is a machine calculated measurement of the average size of platelets. It is generated during automated hematology cell counting along with platelet count & other platelet parameters like PCT, PDW, IPF, PLCR depending upon cell counter used. Until now only platelet count was considered important and used clinically. However MPV may be increased or decreased in various pathological conditions and is currently being investigated as a risk and/or prognostic factor for some diseases.(4) Platelet indices provide valuable insights into platelet production, size, and function. Alterations in platelet indices have been reported in various hematological and non-hematological disorders and may serve as potential biomarkers for diagnosis, prognosis, and monitoring. The analysis of platelet indices in a tertiary care setting can provide important information for the management of patients with various disorders.(5) Several studies reported an inverse relationship between mean platelet volume (MPV) and platelet counts in patients with BTC. This may be related to morphological features of platelets. In the literature, there are also some informations about platelet indices in BTC.(6) Therefore, this study aimed to find out the alteration of MPV in thalassemia major patients in GMERS Medical College & General Hospital, Junagadh.

• A cross-sectional study has taken all thalassemia major patients, whose EDTA samples in haematology lab of pathology department for CBC from indoor patients of GMERS Medical College & General Hospital, Junagadh from January 2025 to June 2025. • Sample Size: 100 thalassemia patients • Inclusion criteria: For all conservative EDTA samples received in haematology lab of pathology department for CBC of thalassemia major patients of GMERS Medical College & General Hospital, Junagadh from January 2025 to June 2025. • Exclusion criteria: patient with thalassemia trait & other hemoglobinopathies. • Sampling Method- EDTA samples were run in abacus 5 parts automated hematology analyzer value of MPV were recorded. • Then data will be classified according to diagnosis and tabulated in excel sheet.

We have taken 100 cases of thalassemia major. out of which 8 (8%) cases showed decrease MPV. Range and mean of MPV were 5fl-7.1fl and 5.96fl respectively. 29 (29%) cases showed normal MPV. Range and mean of MPV were 7.6fl-10.4fl and 8.91fl. 63 (63%) cases showed increase MPV. Range and mean of MPV were 10.6fl-15.6fl and 11.73fl. So majority (63%) of thalassemia major cases showed increase in MPV.

According to Inkal at el.(4)’s control groups MPV range, we have taken 7.5fl-10.5fl as a normal range of MPV. Inkal at el.(4) also noticed majority of thalassemia patient (82.3%) showed increase in MPV and 17.6 % of thalassemia showed decrease in MPV. Limitation of that study, it has not taken thalassemia patient with normal MPV. In present study, we included thalassemia major patient with normal MPV also. So majority of thalassemia patients were also showed increase MPV in present study which is correlated with Inkal at el.(4) In a previous study, it was shown that MPV was significantly correlated with life span of platelets and was related to platelet morphologic change and activation.(8,9) An increase in MPV is also known to be a dependable marker of platelet activation in vivo.(10) Chandra et al.(11) found an interesting point that has to be highlighted in the study is that apart from red cell parameter, platelet parameters including platelet counts, platecrit, and MPV also showed statistical significant difference between IDA and beta thalassemia carrier (BTC). In another study, Labib et al.(12) found no significant difference as regard platelet counts but a significant higher MPV was found in BTC subjects compared with controls. On the other hand, Cikrikcioglu et al.(13) found in the study that, the MPV levels were unexpectedly higher in patients in the BTC group than in the control group. In Hatice Tuba Akbayram at el. , the higher MPV observed in BTC may be related to the fact that hyperactive bone marrow in BTC may lead to release of immature platelets in circulation leading to higher MPV.(6) Eldor A showed In Vivo Platelet Activation in P-Thalassemia Major Reflected by Increased Platelet-Thromboxane Urinary Metabolites.(7)

As india bears huge burden of hemoglobinopathies, and the most prevalent is thalassemia. This study noted majority of thalassemia major patients showed increased mean platelet volume, which suggest the peripheral blood stream of these patients has more than normal number of larger, younger, and more reactive platelets. This may indicate bone marrow of thalassemia major patients has more active megakaryopoiesis with more active ineffective erythropoiesis.

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