plateletssmall

Plateletssmall is a term used in hematology to describe platelets that are smaller than normal circulating platelets, a finding known as microplatelets. Platelets normally range in size, and mean platelet volume (MPV) is a laboratory measure used to quantify platelet size; platelets categorized as small have MPV below the reference range. On a peripheral blood smear, platelets appear diminutive compared with normal platelets and may show normal or reduced granularity.

Small platelets are most commonly encountered in certain inherited thrombocytopenias, notably Wiskott-Aldrich syndrome and related X-linked conditions, where thrombocytopenia accompanies microplatelets. They can also occur in other conditions with defective megakaryopoiesis or platelet production, and in some acquired platelet disorders. The clinical significance depends largely on platelet count and function; individuals with small platelets but normal counts may have minimal bleeding, whereas thrombocytopenia with microplatelets increases bleeding risk.

Diagnosis relies on complete blood count with platelet indices, peripheral smear review, and targeted testing such as genetic sequencing for inherited microplatelet disorders when indicated. Additional studies may include platelet function assays and, in selected cases, bone marrow examination.

Management focuses on the underlying condition. In inherited microplatelet disorders that cause significant bleeding, treatment may include measures to control bleeding, such as antifibrinolytics or desmopressin for mucosal bleeding, and platelet transfusions for major hemorrhage or surgery. Gene therapies in some syndromes are under development, but there is no specific cure for most microplatelet conditions.