Prevalence of Macrothrombocytopenia in Healthy College Students in Western India

  • Parizad Patel
  • Avani Shah
  • Kanchan Mishra
  • Kanjaksha GhoshEmail author
Original Article


Macrothrombocytopenia is being increasingly described across the globe. There is paucity of data on the prevalence of this condition from different parts of India. 10,047 healthy college students from the city of Surat in western India were investigated for macrothrombocytopenia i.e. those with Mean platelet Volume of > 11 fL and platelet count of less than 150 × 109/L. ABO blood groups, complete blood counts, peripheral smear examination and haemoglobinopathy work up was also done. Siblings and parents of the macrothrombocytopenic individuals were also studied when available. Bleeding assessment tool of International society of thrombosis and haemostasis were applied to see if there were excessive bleeding in macrothrombocytropenia patients. One hundred and ninety-six students (1.95%) had asymptomatic macrothrombocytopenia. More female students (P < 0.0001) had this condition and blood group A was under represented (P = 0.019) with this condition. Prevalence of macrothrombocytopenia was not related to ethnic subgroups to which the students belonged to, nor was it linked to presence of any haemoglobinopathy gene. In 38 of the 52, 1st degree relatives studied macrothrombocytopenia was confirmed at least in one of them. Excessive bleeding in none of the individuals with macrothrombocytopenia was noted. Asymptomatic macrothrombocytopenia is rare in western parts of India and affects 1.95% of the healthy population. Females were over represented with this condition raising a suspicion of X linked dominant inheritance. Underrepresentation of blood group A in this condition requires further study.


Macrothrombocytopenia Western India Inherited MPV-ABO blood group Female preponderance 


Authors Contribution

AS & PP collected the sample analysed the results. KM collected the references and along with KG wrote the first draft of the paper. KG wrote the final paper.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest


  1. 1.
    Kunushima S, Saito H (2006) Congenital macrothrombocytopenias. Blood Rev 20:111–121CrossRefGoogle Scholar
  2. 2.
    Savoia A, Balduini CL, Savino M, Noris P, Del Vecchio M, Perrotta S, Belletti S, Poggi IA (2001) Autosomal dominant macrothrombocytopenia in Italy is most frequently a type of heterozygous Bernard-Soulier syndrome. Blood 97:1330–1335CrossRefGoogle Scholar
  3. 3.
    Kakkar N, John MJ, Mathew A (2015) Macrothrombocytopenia in north India: role of automated platelet data in the detection of an under diagnosed entity. Indian J Hematol Blood Transfus 31:61–67CrossRefGoogle Scholar
  4. 4.
    Ali S, Ghosh K, Daly ME, Hampshire DJ, Makris M, Ghosh M, Mukherjee L, Bhattacharya M, Shetty S (2016) Congenital macrothrombocytopenia is a heterogeneous disorder in India. Haemophilia 22:570–582CrossRefGoogle Scholar
  5. 5.
    Ali S, Shetty S, Ghosh K (2017) A novel mutation in GP1BA gene leads to mono-allelic Bernard Soulier syndrome form of macrothrombocytopenia. Blood Coagul Fibrinolysis 28:94–95CrossRefGoogle Scholar
  6. 6.
    Ali S, Ghosh K, Shetty S (2017) Differential expression of genes involved in Bengal macrothrombocytopenia (BMTCP). Blood Cells Mol Dis 55(4):410–414CrossRefGoogle Scholar
  7. 7.
    Naina HV, Nair SC, Daniel D, George B, Chandy M (2002) Asymptomatic constitutional macrothrombocytopenia among West Bengal blood donors. Am J Med 112:742–743CrossRefGoogle Scholar
  8. 8.
    Rodeghiero F, Tosetto A, Abshire T, Arnold DM, Coller B, James P, Neunert C, Lillicrap D, ISTH/SSC joint VWF and Perinatal/Pediatric Hemostasis Subcommittees Working Group (2010) ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders. J Thromb Haemost 8:2063–2065CrossRefGoogle Scholar
  9. 9.
    O’Brien SH (2012) Bleeding scores: Are they useful? Hematol Am Soc Hemotol Educ Program 2012:152–156Google Scholar
  10. 10.
    Bain B, Bates I, Laffan M (eds) (2017) Dacie & Lewis practical haematology, 12th edn. Elsevier, LondonGoogle Scholar
  11. 11.
  12. 12.
    Jamwal M, Aggarwal A, Maitra A, Sharma P, Bansal D, Trehan A et al (2017) First report of Mediterranean stomatocytosis/macrothrombocytopenia in an Indian family: a diagnostic dilemma. Pathology 49:811–815CrossRefGoogle Scholar
  13. 13.
    Deb RA, Choudhury N, Ray D (2015) Giant platelets in platelet donors—a blessing in disguise. J Clin Diagn Res 9:EC01–EC03Google Scholar
  14. 14.
    Ali S, Shetty S, Ghosh K (2016) Bengal macrothrombocytopenia is not totally an innocuous condition. Blood Cells Mol Dis 60:3–6CrossRefGoogle Scholar
  15. 15.
    Bain BJ (1985) Platelet count and platelet size in males and females. Scand J Haematol 35:77–79CrossRefGoogle Scholar
  16. 16.
    Butkiewicz AM, Kemona H, Dymicka-Piekarska V, Matowicka-Karna J, Radziwon P, Lipska A (2006) Platelet count, mean platelet volume and thrombocytopoietic indices in healthy women and men. Thromb Res 118:199–204CrossRefGoogle Scholar
  17. 17.
    Wendy AC, Wendy HR, Melissa AK (2008) Human phenotypes with GATA-1 mutations. Gene 427:1–6CrossRefGoogle Scholar
  18. 18.
    Lee HR, Park JS, Shin S, Roh EY, Yoon JH, Song EY et al. (2013) Mean platelet volume reflect hematopoietic potency and correlated blood group o in cord blood from healthy newborn. Biomed Res Int 754169. (Epub 2013 Mar 27:754169)
  19. 19.
    Noris P, Klersy C, Gresele P, Giona F, Giordano P, Minuz P et al (2013) Platelet size for distinguishing between inherited thrombocytopenias and immune thrombocytopenia: a multicentric, real life study. Br J Haematol 162:112–119CrossRefGoogle Scholar
  20. 20.
    Bhat R, Pai S (2016) Immature platelet fraction: a significant platelet parameter in asymptomatic constitutional macrothrombocytopenia. Int J Lab Hematol 38:e45–e47CrossRefGoogle Scholar
  21. 21.
    Fiore M, Pillois X, Lorrain S, Bernard MA, Moore N, Sié P, Viallard JF, Nurden P (2016) A diagnostic approach that may help to discriminate inherited thrombocytopenia from chronic immune thrombocytopenia in adult patients. Platelets 27:555–562CrossRefGoogle Scholar

Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  1. 1.Surat Raktadan Kendra & Research CentreSuratIndia

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