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Immune thrombocytopenic purpura (ITP) is a common cause of thrombocytopenia in pediatric patients, often requiring differentiation from hypoproductive thrombocytopenia. This study assesses the diagnostic accuracy of immature platelet fraction (IPF) parameters in distinguishing ITP from hypoproductive thrombocytopenia.
A cross-sectional study was conducted at Hazrat Ali Asghar Hospital, Tehran, enrolling 165 children under 18 years with confirmed thrombocytopenia (platelet count <150 × 10^9/L). Participants were selected based on specific inclusion and exclusion criteria. Data were collected using a pre-designed checklist, and complete blood counts with a particular focus on IPF measurements were performed using the BC-6800 automated hematology analyzer. Clinical diagnoses of ITP and hypoproductive thrombocytopenia were confirmed via bone marrow examination and immunophenotyping. Statistical analyses included receiver operating characteristic (ROC) curve analysis to evaluate the diagnostic performance of IPF.
The mean IPF for patients with ITP was significantly higher than for those without (30.5 ± 12.9 vs. 7.4 ± 3.4, P < 0.001). The ROC curve analysis yielded an area under the curve (AUC) of 0.96, indicating excellent discriminative ability of IPF. The optimal cutoff value for IPF was determined to be 11.20%, with a sensitivity of 0.97 and specificity of 0.94. Multivariate analysis confirmed an independent association between higher IPF levels and ITP diagnosis (adjusted odds ratio = 1.25, 95% CI: 1.10 - 1.43, P < 0.001).
The IPF parameter is a reliable and sensitive diagnostic tool for differentiating ITP from hypoproductive thrombocytopenia in pediatric patients. This study supports the integration of IPF measurement into clinical practice to enhance diagnostic accuracy in children with thrombocytopenia.
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