Confounding Factors May Affect Mean Platelet Volume in Chronic Urticaria

I read the article by Isiksacan et al with interest. They assessed the association between mean platelet volume (MPV) and chronic urticaria. Mean platelet volume in patients with chronic urticaria was significantly lower than that in healthy controls. There were no significant differences in platelet distribution width and platelet counts between the groups. There are some methodological limitations in this study from the aspect of platelet indices. Previous studies showed that many cardiovascular (CV) risk factors affect the MPV, such as obesity, hypertension, smoking, hyperlipidemia, diabetes mellitus, prediabetes, atrial fibrillation, metabolic syndrome, fatty liver disease, and rheumatic and inflammatory chronic diseases. Although the authors excluded patients with CV diseases, these factors should be taken into account for accurate MPV assessment. The MPV is included within a full blood count. Larger platelets aggregate more with collagen, have more granules, express more glycoprotein Ib and IIb/IIIa receptors, and have greater thromboxane A2 release. Previous studies showed that many CV risk factors and CV diseases can affect MPV. These confounding factors should be considered.