Back­ground: Evaluation of thrombocytopenia involves a meticulous approach in which complete clinical history, clinical examination, complete hemogram and bone marrow aspiration if indicated, are included. The various platelet indices produced by the automated analysers such as, Mean platelet volume (MPV), Platelet distribution width (PDW), Plateletcrit (PCT) and Large cell ratio (LCR) can be used to distinguish the underlying etiology of thrombocytopenia.

Methods: Total of seventy three thrombocytopenic patients<14 years with proper clinic–hematological work up were included in the study. The results were compared by manual examination of the peripheral blood smear.

Results: Patients were grouped based on the mechanism– Peripheral destruction 54 (73.9%), Hypoproduction 10 (13.6%), Hypersplenism 9 (12.3%).There was a linear correlation between the platelet count and all the platelet derived indices (MPV, PDW, PCT, LCR) in the patients with peripheral destruction of platelets.The p–value of all the derivatives was statistically significant (level of significance less than 0.05). In patients with hypoproduction and hypersplenism,therewas positive correlationbetween the platelet count and MPV, PDW, PCT & LCR.None of the p–values were statistically significant.

Conclusions:Platelet indices especially MPV and PDW can be used as important initial and supportive tool to differentiate between the hyperdestructive versus hypoprodution and hypersplenism cases.