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CRP Levels, Thrombocyte Index and Coagulation Status with TEG Profile in ITP Patients

  • Suryanto Suryanto ,
  • Banundari Racmawati ,
  • Imam Budiwiyono ,


Examinations related to Immune Thrombocytopenia (ITP) cases have been widely demonstrated in diagnosing and monitoring hemostasis status. The increased MPV and PDW have a high sensitivity to the diagnosis of ITP and CRP is one of the causes of ITP. Monitoring of bleeding in ITP still uses conventional examination. Thromboelastography (TEG) is a global hemostasis assessment tool that assesses real-time overall hemostasis. TEG profiles especially MA and R-time can be used for case assessment of ITP patients. This research describes the correlation between CRP levels, platelet index and coagulation status with TEG profiles (MA and R-time) in ITP patients. This research used analytical observational with cross sectional approach. A sample of 32 respondents aged >18 years with a platelet count <150,000/mm3. Then the respondents measured EDTA blood samples for platelet index (MPV and PDW) and CRP levels, in the citrate blood sample 3.2% measured coagulation status (aPTT and PT) as well as examining the TEG profile, especially R-time and MA. Correlation test uses the Pearson test for data that is normally distributed, while the Spearman test is for data that are not normally distributed. There is a correlation between CRP levels, platelet counts, MPV and MA TEG (p=0.002, p=0.000, p=0.001), there is no correlation between PDW and MA TEG (p=0.06), there is a correlation between aPTT and R-time TEG (p=0.001) and there is no correlation between PT and R-time TEG (p=0.667). Overall, there is a correlation between conventional variables and the TEG profile in ITP patients.


  1. Ntaios G, Papadopoulos A, Chatzinikolaou A, Saouli Z, Karalazou P, Kaiafa G, et al. Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura. Acta Haematol. 2008;119(3):173–7.
  2. Michel M. Immune thrombocytopenic purpura: epidemiology and implications for patients. Eur J Haematol. 2009 Mar;82:3–7.
  3. Zainal A, Salama A, Alweis R. Immune thrombocytopenic purpura. J Community Hosp Intern Med Perspect. 2019 Feb 11;9(1):59–61.
  4. Zufferey A, Kapur R, Semple J. Pathogenesis and Therapeutic mechanisms in immune thrombocytopenia (ITP). J Clin Med. 2017 Feb 9;6(2):16.
  5. Ahmed MU. Role of mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) value in the diagnosis of immune thrombocytopenic purpura. Hematol Transfus Int J. 2016 Feb 17;2(2).
  6. Lee E, Kim M, Jeon K, Lee J, Lee J-S, Kim H-S, et al. Mean platelet volume, platelet distribution width, and platelet count, in connection with immune Thrombocytopenic purpura and essential thrombocytopenia. Lab Med. 2019 Jul 16;50(3):279– 85.
  7. Kapur R, Heitink-Pollé KMJ, Porcelijn L, Bentlage AEH, Bruin MCA, Visser R, et al. C-reactive protein enhances IgG-mediated phagocyte responses and thrombocytopenia. Blood. 2015 Mar 12;125(11):1793– 802.
  8. Semple JW. C-reactive protein boosts antibody-mediated platelet destruction. Blood. 2015 Mar 12;125(11):1690–1.
  9. Pan J-Q, Wang W, Wang M-L, Li X-Y, Wang J-H, Zhao W-W, et al. Recognition of the human antibody-mediated platelet destruction in adult ITP patients by C-reactive protein. Int J Clin Exp Pathol. 2017;10(10).
  10. Samama CM. Thromboelastography: The Next Step. :2. Anesth Analg. 2001 Mar;92(3):563-4
  11. Thakur M, Ahmed AB. A Review of Thromboelastography. Gaur A, editor. Int J Perioper Ultrasound Appl Technol. 2012 Jan;1:25–9.
  12. Haemoscope Devision. TEG 5000 System - User Manual -. Haemonetics Corporation; 2011.
  13. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol. 2005 Mar;128(5):698–702.
  14. Kroll MH. Thromboelastography: theory and practice in measuring hemostasis, Clinical Laboratory News. AACC. 2010;36(12):8–10.
  15. Galvez C. K, Cortes L. C. Thromboelastography: new concepts in haemostasis physiology and correlation with trauma associated coagulopathy. Colomb J Anesthesiol. 2012 Aug;40(3):224–30.
  16. Williams L. Thrombophilia. In: McKenzie SB, Williams LJ, editors. Clinical Laboratory Hematology. 2nd ed. Boston: Pearson; 2010. 731–61 p.
  17. Tripodi A, Groot PG de, Pengo V. Antiphospholipid syndrome: laboratory detection, mechanisms of action and treatment. J Intern Med. 2011;270(2):110–22.
  18. Ganter MT, Hofer CK. Coagulation monitoring: current techniques and clinical use of viscoelastic point-of-care
  19. coagulation devices. Anesth Analg. 2008 May;106(5):1366–75.
  20. Wijaya S. Immune thrombocytopenia. Cermin Dunia Kedokt. 2019;46(11):658–61.
  21. Wu L, Zhang G, Guo C. Thromboelastography detects possible coagulation disturbance in pediatric patients with portal cavernoma. Transfus Med Hemotherapy. 2020 Apr;47(2):135–43.

How to Cite

Suryanto, S., Racmawati, B., & Budiwiyono, I. (2021). CRP Levels, Thrombocyte Index and Coagulation Status with TEG Profile in ITP Patients. Bali Medical Journal, 10(3), 1347–1353.




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Suryanto Suryanto
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BMJ Journal

Banundari Racmawati
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Imam Budiwiyono
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BMJ Journal