Mean Platelet Volume (MPV): Interpretation of High and Low Values

MPV Basics

MPV (femtoliters, fL) reflects average platelet size. Normal: 7.5–12.5 fL.

Elevated MPV (>12.5 fL)

• Increased platelet turnover: immune thrombocytopenia (ITP), recovery from chemotherapy, myeloproliferative neoplasms (ET, PMF).
• Nutritional: iron, B12, folate deficiency (ineffective thrombopoiesis → larger young platelets).
• Inflammatory states, diabetes, cardiovascular risk marker.

Decreased MPV (<7.5 fL)

• Decreased production: aplastic anemia, marrow infiltration.
• Hereditary macrothrombocytopenias: Bernard‑Soulier, MYH9‑related disorders (paradoxically large platelets but low MPV on some analyzers).
• Wiskott‑Aldrich syndrome (small platelets).

Clinical Context

MPV alone is nonspecific. Interpret with platelet count, peripheral smear, and clinical picture.