Platelets play a major function in sealing the openings in the vascular tree by forming the primary hemostatic plug [1]. There are clear age-related changes in platelet count and function, driven by changes in hematopoietic tissue, the composition of the blood and vascular health [2].

Platelets play a key role in primary hemostasis and mediate immune defense. Platelet count decreases during aging, is higher in women than in men [3].

The normal platelet count (defined as the values between percentiles 2.5 to 97.5 in normal individuals) is given as 150 to 400 × 109/L; classically, thrombocytopenia is defined as a platelet count of less than 150 × 109/L. Thrombocytopenia can be classified as severe (platelet count less than 20 × 109/L), moderate (platelet count 20 to 70 ×109/L), or mild (above 70 × 109/L) [4].

Idiopathic thrombocytopenic purpura (ITP) platelets get coated by antibodies and those platelets are destroyed by the cells of mononuclear phagocytic system in the spleen [5].

Chronic ITP is a disease of adults due to the synthesis of antibodies against GP IIb /IIIa or GP Ib/IX antigens on platelet surface. Bleeding time (BT) is prolonged and PT, APTT are normal. Bone marrow examination is not diagnostic of ITP. Bizzoni et al. retrospective study, concluded that, in elderly patients, ITP is a relatively benign disease [6].

1. To study the variation of platelet count in Geriatric age group of both sex.

2. To study the grading of variation in platelet count in geriatrics with clinicopathological correlation.

Inclusion criteria: All men and women aged 60 years and above.

Exclusion criteria: 

1. Clotted blood sample and inadequate blood sample.

2. All men and women aged less than 60 years.

Type of Study and Period: Prospective two years study (from May 2018 to April 2020).

Sample Size and Statistical Analysis: Considering 95% confidence limit with 5% of confidence interval, minimum sample size is 340. Present study included 400 as a sample size.

Statistical analysis: Data was entered into Microsoft excel data sheet and analyzed using SPSS 22 version software. One sample or two sample t test with mean and standard deviation was done for the significance of the data

Graphical representation of data: MS Excel and MS word was used to obtain various graphs. P value (probability that the result is true) of <0.05 was considered as statistically significant after considering all the rules of the tests.

Collection of Data: After the informed consent, under aseptic precaution blood sample was taken into EDTA tube, then sample were  analyzed for CBC by using SYSMEX XN-350 series hematology autoanalyzer later peripheral smears were  made and stained with Leishman stain. Brief clinical details collected

The present study includes 400 elderly patients aged 60 years and above conducted in the department of Pathology, Karnataka institute of medical sciences, Hubballi.

The present study showed male predominance of about 58.25% (233) cases majority of cases between age group 60-69 years (237 cases) with, and females population comprised around 41.75% (167) cases [Fig. 1].         

The study found that out of 72 cases of thrombocytopenia, half of the cases were having mild decrease in the platelet count 50 % (36) cases ,moderate and severe grade of thrombocytopenia was seen in 21% (15 ) cases and  19% (14) cases. very severe thrombocytopenia was seen in 10% (7) cases [Fig. 2].

The present study [Table. 1] found that 75.25% (301) of cases were having normal levels of platelet count, 18 (72) cases showed thrombocytopenia and 6.75% (27) cases showed reactive  thrombocytosis [Fig. 3].

One case of ITP (Immune thrombocytopenic purpura) was diagnosed after the bone marrow studies. Microscopy of bone marrow studies showed increase the number of megakaryocytes.

Platelets are the one’s which play a major role in acute bleeding manifestation by forming a primary haemostatic plug and also shows age related variations in its value. 

In the present study 171 males and 130 females had normal platelet count. 

Among these 50 males and 22 females showed platelet count less than 1.5 lakhs/cumm. Both males (30 cases) and females (13 cases) presented with thrombocytopenia predominantly in 6th decade. Almost the values were within the normal limit in both 8th and 9th decade [Table. 2].

The present study found that gender dependent variation with high platelet count in the elderly females and many other studies also found the same inference. Butkiewicz et al. [9] study also showed that females having the high variation of platelet count with respect to age [Table. 3].

Present study showed majority of geriatric patients with mild degree of thrombocytopenia, which was consistent with the Sampat Kumar et al. [10], but other studies as shown in [Table. 4] of comparison had moderate degree of thrombocytopenia.

In the present study gastrointestinal causes like liver disease, anemia of chronic disease were the common causes for the blood loss. One case of endometrial cancer was seen in the elderly female presented with vaginal bleeding [Table. 5].

The present study had one case of ITP found in the male (6th decade) with normocytic and neutrophilic leucocytosis picture on the peripheral smear with 42,000 platelet count. Bone marrow shows Hypercellularity. Patient had history of chronic kidney disease on treatment [Fig. 4].

Platelet count significantly showed the variation as the aging progress. Diagnosis and Grading of thrombocytopenia in geriatrics play a crucial impact on the treating clinician, for the further systemic and therapeutic approach towards the patients.