VPM (volume plaquettaire moyen) : interpr\u00e9tation clinique et causes d'anomalie | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Le VPM mesure la taille moyenne des plaquettes. VPM \u00e9lev\u00e9 thrombop\u00e9nie immune destruction accrue, VPM bas thrombop\u00e9nie production insuffisante aplasie, thrombocytose et bilan h\u00e9matologique au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"VPM, volume plaquettaire moyen, VPM \u00e9lev\u00e9, VPM thrombop\u00e9nie, VPM plaquettes, VPM bas, VPM interpr\u00e9tation, plaquettes VPM, thrombop\u00e9nie VPM, VPM Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=dump');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Hematology & Clinical Biochemistry & Family Medicine<\/span>\n <h1>VPM \u2014 Volume plaquettaire moyen<\/h1>\n\n <div class=\"co-intro\">\n Le volume plaquettaire moyen (VPM) \u2014 d\u00e9sign\u00e9 MPV (Mean Platelet Volume) dans les pays anglophones \u2014 est un param\u00e8tre plaquettaire calcul\u00e9 automatiquement par l'h\u00e9mogramme (NFS) mesurant le volume moyen d'une plaquette en femtolitres (fl). Sa valeur normale est de 7,5 \u00e0 12,5 fl selon les laboratoires + avec des variations selon le type d'automate utilis\u00e9 + l'anticoagulant (EDTA vs citrate) + et le d\u00e9lai d'analyse (les plaquettes gonflent dans l'EDTA avec le temps). Le VPM refl\u00e8te indirectement l'activit\u00e9 de production m\u00e9gacaryocytaire m\u00e9dullaire : les grandes plaquettes (VPM \u00e9lev\u00e9) sont m\u00e9taboliquement plus actives + plus riches en granules + et plus thrombog\u00e8nes + correspondant g\u00e9n\u00e9ralement \u00e0 des plaquettes jeunes r\u00e9cemment lib\u00e9r\u00e9es en r\u00e9ponse \u00e0 une destruction ou consommation p\u00e9riph\u00e9rique accrue \u2014 comme dans la thrombop\u00e9nie immune p\u00e9riph\u00e9rique (PTI) + l'h\u00e9morragie aigu\u00eb + ou la destruction m\u00e9canique. Les petites plaquettes (VPM bas) signalent \u00e0 l'inverse une production m\u00e9dullaire insuffisante (aplasie + my\u00e9lodysplasie + chimioth\u00e9rapie + infiltration m\u00e9dullaire) o\u00f9 la moelle osseuse ne peut pas produire suffisamment de plaquettes en r\u00e9ponse \u00e0 la thrombop\u00e9nie. Cette distinction entre thrombop\u00e9nie par destruction accrue (VPM \u00e9lev\u00e9 + moelle r\u00e9actionnelle) et thrombop\u00e9nie par production insuffisante (VPM bas + moelle d\u00e9faillante) est cliniquement et th\u00e9rapeutiquement fondamentale : dans le premier cas la moelle est fonctionnelle et le traitement vise \u00e0 r\u00e9duire la destruction + dans le second cas la moelle est d\u00e9faillante et il faut traiter la cause m\u00e9dullaire. Le VPM doit toujours \u00eatre interpr\u00e9t\u00e9 avec le compte plaquettaire total + la NFS compl\u00e8te + et le contexte clinique + car il peut \u00eatre faussement normal dans les formes mixtes ou lors de variations pr\u00e9analytiques.\n <\/div>\n\n <h2>Valeurs normales et interpr\u00e9tation<\/h2>\n <ul class=\"co-list\">\n <li><strong>Normal VPM<\/strong> 7.5\u201312.5 fl (depending on laboratory and automated analyzer) + normal-sized platelets + balanced bone marrow production<\/li>\n <li><strong>VPM \u00e9lev\u00e9 (>12,5 fl) \u2014 macrothrombocytes :<\/strong> Large and young platelets \u2192 signal of increased reactive medullary production in response to peripheral destruction or consumption + or intrinsic abnormality of megakaryocytes<\/li>\n <li><strong>VPM bas (<7,5 fl) \u2014 microthrombocytes :<\/strong> small platelets \u2192 insufficient or defective bone marrow production + or Wiskott-Aldrich syndrome (pathognomonic microthrombocytes)<\/li>\n <li><strong>Art\u00e9fact pr\u00e9analytique fr\u00e9quent :<\/strong> les plaquettes gonflent dans l'EDTA avec le temps \u2192 le VPM augmente artificiellement si l'analyse est retard\u00e9e >1 heure \u2192 pr\u00e9l\u00e8vements sur citrate ou analyse imm\u00e9diate pour les VPM limites<\/li>\n <\/ul>\n\n <h2>VPM \u00e9lev\u00e9 \u2014 orientation diagnostique<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Condition<\/th>\n <th>VPM<\/th>\n <th>Plaquettes<\/th>\n <th>Mechanism<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Purpura thrombop\u00e9nique immunologique (PTI)<\/td>\n <td>\u00c9lev\u00e9 ++ (>12 fl)<\/td>\n <td>Basses (<100 G\/L)<\/td>\n <td>Destruction p\u00e9riph\u00e9rique par auto-anticorps anti-plaquettes \u2192 m\u00e9gacaryocytes compensent \u2192 lib\u00e8rent des plaquettes g\u00e9antes jeunes<\/td>\n <\/tr>\n <tr>\n <td>Thrombop\u00e9nie par destruction m\u00e9canique (CIVD + PTT + SHU)<\/td>\n <td>High<\/td>\n <td>Tr\u00e8s basses<\/td>\n <td>Fragmentation et consommation p\u00e9riph\u00e9rique \u2192 compensation m\u00e9dullaire r\u00e9actionnelle<\/td>\n <\/tr>\n <tr>\n <td>H\u00e9morragie aigu\u00eb<\/td>\n <td>\u00c9lev\u00e9 (transitoire)<\/td>\n <td>Normales \u00e0 basses (selon importance)<\/td>\n <td>Lib\u00e9ration de plaquettes jeunes en r\u00e9ponse aux pertes<\/td>\n <\/tr>\n <tr>\n <td>Hypothyroidism<\/td>\n <td>High<\/td>\n <td>Variables<\/td>\n <td>M\u00e9canisme impr\u00e9cis \u2014 modifications de la thrombopo\u00ef\u00e8se + plaquettes plus grandes et plus actives<\/td>\n <\/tr>\n <tr>\n <td>Syndrome m\u00e9tabolique + diab\u00e8te + ob\u00e9sit\u00e9<\/td>\n <td>L\u00e9g\u00e8rement \u00e9lev\u00e9<\/td>\n <td>Normal<\/td>\n <td>Activation plaquettaire chronique + inflammation + stress oxydatif \u2192 marqueur de risque cardiovasculaire r\u00e9siduel (association \u00e9pid\u00e9miologique)<\/td>\n <\/tr>\n <tr>\n <td>Thrombocytose r\u00e9actionnelle (inflammation + carence martiale)<\/td>\n <td>Variable + souvent normal ou l\u00e9g\u00e8rement \u00e9lev\u00e9<\/td>\n <td>\u00c9lev\u00e9es (>450 G\/L)<\/td>\n <td>Stimulation de la thrombopo\u00ef\u00e8se par IL-6 et thrombopo\u00ef\u00e9tine en contexte inflammatoire<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>VPM bas \u2014 orientation diagnostique<\/h2>\n <ul class=\"co-list\">\n <li><strong>Aplasie m\u00e9dullaire :<\/strong> VPM low + pancytopenia + collapsed reticulocytes \u2192 empty marrow \u2192 myelogram essential + treatment: cyclosporine + ALS (anti-lymphocyte serum) + stem cell transplant<\/li>\n <li><strong>My\u00e9lodysplasie :<\/strong> VPM (dysplastic platelets) + macrocytosis + variable cytopenias \u2192 bone marrow biopsy + karyotype \u2192 risk of transformation into AML<\/li>\n <li><strong>Infiltration m\u00e9dullaire (m\u00e9tastases + lymphomes + leuc\u00e9mies) :<\/strong> hematopoietic bone marrow replacement \u2192 thrombocytopenia + low MPV + leucoerythroblastosis on peripheral blood smear (presence of erythroblasts + myelocytes in peripheral blood)<\/li>\n <li><strong>Chimioth\u00e9rapie + radioth\u00e9rapie my\u00e9losuppressive :<\/strong> Direct toxicity to megakaryocytes \u2192 thrombocytopenia + low transient MPV + recovery in 2\u20133 weeks after cessation<\/li>\n <li><strong>Wiskott-Aldrich Syndrome:<\/strong> maladie rare li\u00e9e \u00e0 l'X + microthrombocytes pathognomoniques (VPM tr\u00e8s bas + <5 fl) + ecz\u00e9ma + d\u00e9ficit immunitaire combin\u00e9 + thrombop\u00e9nie s\u00e9v\u00e8re<\/li>\n <li><strong>B12 and folate deficiency<\/strong> Megaloblastic dysthrombopoiesis \u2192 small platelets + dysfunctional + often in context of pancytopenia<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La combinaison thrombop\u00e9nie + VPM \u00e9lev\u00e9 oriente vers une destruction p\u00e9riph\u00e9rique (PTI + CIVD + PTT) avec une moelle r\u00e9active \u2014 dans ce cas, la moelle est fonctionnelle et lib\u00e8re des plaquettes jeunes et grandes en compensation. \u00c0 l'inverse, la combinaison thrombop\u00e9nie + VPM bas oriente vers une insuffisance de production m\u00e9dullaire (aplasie + my\u00e9lodysplasie + infiltration + chimioth\u00e9rapie) \u2014 dans ce cas la moelle est d\u00e9faillante et ne peut pas compenser la thrombop\u00e9nie. Cette distinction oriente directement vers le my\u00e9logramme si VPM bas + thrombop\u00e9nie inexpliqu\u00e9e, versus vers la recherche d'une cause de destruction p\u00e9riph\u00e9rique si VPM \u00e9lev\u00e9.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si une thrombop\u00e9nie est d\u00e9couverte sur la NFS \u2014 qu'elle s'accompagne d'un VPM \u00e9lev\u00e9 (destruction p\u00e9riph\u00e9rique probable) ou d'un VPM bas (insuffisance m\u00e9dullaire probable) + particuli\u00e8rement si le compte plaquettaire est inf\u00e9rieur \u00e0 50 G\/L + ou si des signes h\u00e9morragiques sont pr\u00e9sents (p\u00e9t\u00e9chies + ecchymoses + saignements muqueux). Une thrombop\u00e9nie s\u00e9v\u00e8re (<20 G\/L) avec signes h\u00e9morragiques actifs constitue une urgence m\u00e9dicale. Pour le bilan complet des anomalies plaquettaires et l'interpr\u00e9tation du VPM, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron interpr\u00e8tent le VPM dans le contexte clinique et avec l'ensemble de la NFS, distinguent la thrombop\u00e9nie par destruction p\u00e9riph\u00e9rique (VPM \u00e9lev\u00e9 \u2014 PTI + CIVD) de la thrombop\u00e9nie par insuffisance m\u00e9dullaire (VPM bas \u2014 aplasie + my\u00e9lodysplasie), prescrivent le frottis sanguin pour confirmation + le bilan \u00e9tiologique cibl\u00e9, orientent vers l'h\u00e9matologie pour le my\u00e9logramme si une cause m\u00e9dullaire est suspect\u00e9e, et assurent le suivi des thrombop\u00e9nies chroniques. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un h\u00e9matologue. Le VPM est sujet \u00e0 des variations pr\u00e9analytiques importantes \u2014 les plaquettes gonflent dans l'EDTA avec le temps, augmentant artificiellement le VPM si l'analyse est retard\u00e9e. Un VPM isol\u00e9ment \u00e9lev\u00e9 ou bas sans thrombop\u00e9nie ni autre anomalie de la NFS est rarement cliniquement significatif.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>VPM (volume plaquettaire moyen) : interpr\u00e9tation clinique et causes d’anomalie | Clinique Omicron H\u00e9matologie & Biochimie clinique & M\u00e9decine de famille VPM \u2014 Volume plaquettaire moyen Le volume plaquettaire moyen (VPM) \u2014 d\u00e9sign\u00e9 MPV (Mean Platelet Volume) dans les pays anglophones \u2014 est un param\u00e8tre plaquettaire calcul\u00e9 automatiquement par l’h\u00e9mogramme (NFS) mesurant le volume moyen… <a href=\"https:\/\/cliniqueomicron.ca\/en\/volume-plaquettaire-moyen-vpm\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">MPV (mean platelet volume): clinical interpretation and causes of abnormality | Omicron Clinic<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Volume plaquettaire moyen VPM | Brossard | Clinique Omicron","_metasync_otto_description":"Volume plaquettaire moyen VPM Volume plaquettaire moyen VPM est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test...","_metasync_otto_keywords":"volume plaquettaire moyen vpm, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"","_metasync_otto_og_description":"Volume plaquettaire moyen VPM Volume plaquettaire moyen VPM est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Volume plaquettaire moyen VPM Volume plaquettaire moyen VPM est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"VPM (volume plaquettaire moyen) : interpr\u00e9tation clinique et causes d'anomalie | Clinique Omicron","_aioseo_description":"Le VPM mesure la taille moyenne des plaquettes. 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\n\t\t\t\t\t\n\n\n\n\nVPM (volume plaquettaire moyen) : interpr\u00e9tation clinique et causes d'anomalie | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Le VPM mesure la taille moyenne des plaquettes. 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Sa valeur normale est de 7,5 \u00e0 12,5 fl selon les laboratoires + avec des variations selon le type d'automate utilis\u00e9 + l'anticoagulant (EDTA vs citrate) + et le d\u00e9lai d'analyse (les plaquettes gonflent dans l'EDTA avec le temps). Le VPM refl\u00e8te indirectement l'activit\u00e9 de production m\u00e9gacaryocytaire m\u00e9dullaire : les grandes plaquettes (VPM \u00e9lev\u00e9) sont m\u00e9taboliquement plus actives + plus riches en granules + et plus thrombog\u00e8nes + correspondant g\u00e9n\u00e9ralement \u00e0 des plaquettes jeunes r\u00e9cemment lib\u00e9r\u00e9es en r\u00e9ponse \u00e0 une destruction ou consommation p\u00e9riph\u00e9rique accrue \u2014 comme dans la thrombop\u00e9nie immune p\u00e9riph\u00e9rique (PTI) + l'h\u00e9morragie aigu\u00eb + ou la destruction m\u00e9canique. Les petites plaquettes (VPM bas) signalent \u00e0 l'inverse une production m\u00e9dullaire insuffisante (aplasie + my\u00e9lodysplasie + chimioth\u00e9rapie + infiltration m\u00e9dullaire) o\u00f9 la moelle osseuse ne peut pas produire suffisamment de plaquettes en r\u00e9ponse \u00e0 la thrombop\u00e9nie. Cette distinction entre thrombop\u00e9nie par destruction accrue (VPM \u00e9lev\u00e9 + moelle r\u00e9actionnelle) et thrombop\u00e9nie par production insuffisante (VPM bas + moelle d\u00e9faillante) est cliniquement et th\u00e9rapeutiquement fondamentale : dans le premier cas la moelle est fonctionnelle et le traitement vise \u00e0 r\u00e9duire la destruction + dans le second cas la moelle est d\u00e9faillante et il faut traiter la cause m\u00e9dullaire. Le VPM doit toujours \u00eatre interpr\u00e9t\u00e9 avec le compte plaquettaire total + la NFS compl\u00e8te + et le contexte clinique + car il peut \u00eatre faussement normal dans les formes mixtes ou lors de variations pr\u00e9analytiques.\n <\/div>\n\n <h2>Valeurs normales et interpr\u00e9tation<\/h2>\n <ul class=\"co-list\">\n <li><strong>Normal VPM<\/strong> 7.5\u201312.5 fl (depending on laboratory and automated analyzer) + normal-sized platelets + balanced bone marrow production<\/li>\n <li><strong>VPM \u00e9lev\u00e9 (>12,5 fl) \u2014 macrothrombocytes :<\/strong> Large and young platelets \u2192 signal of increased reactive medullary production in response to peripheral destruction or consumption + or intrinsic abnormality of megakaryocytes<\/li>\n <li><strong>VPM bas (<7,5 fl) \u2014 microthrombocytes :<\/strong> small platelets \u2192 insufficient or defective bone marrow production + or Wiskott-Aldrich syndrome (pathognomonic microthrombocytes)<\/li>\n <li><strong>Art\u00e9fact pr\u00e9analytique fr\u00e9quent :<\/strong> les plaquettes gonflent dans l'EDTA avec le temps \u2192 le VPM augmente artificiellement si l'analyse est retard\u00e9e >1 heure \u2192 pr\u00e9l\u00e8vements sur citrate ou analyse imm\u00e9diate pour les VPM limites<\/li>\n <\/ul>\n\n <h2>VPM \u00e9lev\u00e9 \u2014 orientation diagnostique<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Condition<\/th>\n <th>VPM<\/th>\n <th>Plaquettes<\/th>\n <th>Mechanism<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Purpura thrombop\u00e9nique immunologique (PTI)<\/td>\n <td>\u00c9lev\u00e9 ++ (>12 fl)<\/td>\n <td>Basses (<100 G\/L)<\/td>\n <td>Destruction p\u00e9riph\u00e9rique par auto-anticorps anti-plaquettes \u2192 m\u00e9gacaryocytes compensent \u2192 lib\u00e8rent des plaquettes g\u00e9antes jeunes<\/td>\n <\/tr>\n <tr>\n <td>Thrombop\u00e9nie par destruction m\u00e9canique (CIVD + PTT + SHU)<\/td>\n <td>High<\/td>\n <td>Tr\u00e8s basses<\/td>\n <td>Fragmentation et consommation p\u00e9riph\u00e9rique \u2192 compensation m\u00e9dullaire r\u00e9actionnelle<\/td>\n <\/tr>\n <tr>\n <td>H\u00e9morragie aigu\u00eb<\/td>\n <td>\u00c9lev\u00e9 (transitoire)<\/td>\n <td>Normales \u00e0 basses (selon importance)<\/td>\n <td>Lib\u00e9ration de plaquettes jeunes en r\u00e9ponse aux pertes<\/td>\n <\/tr>\n <tr>\n <td>Hypothyroidism<\/td>\n <td>High<\/td>\n <td>Variables<\/td>\n <td>M\u00e9canisme impr\u00e9cis \u2014 modifications de la thrombopo\u00ef\u00e8se + plaquettes plus grandes et plus actives<\/td>\n <\/tr>\n <tr>\n <td>Syndrome m\u00e9tabolique + diab\u00e8te + ob\u00e9sit\u00e9<\/td>\n <td>L\u00e9g\u00e8rement \u00e9lev\u00e9<\/td>\n <td>Normal<\/td>\n <td>Activation plaquettaire chronique + inflammation + stress oxydatif \u2192 marqueur de risque cardiovasculaire r\u00e9siduel (association \u00e9pid\u00e9miologique)<\/td>\n <\/tr>\n <tr>\n <td>Thrombocytose r\u00e9actionnelle (inflammation + carence martiale)<\/td>\n <td>Variable + souvent normal ou l\u00e9g\u00e8rement \u00e9lev\u00e9<\/td>\n <td>\u00c9lev\u00e9es (>450 G\/L)<\/td>\n <td>Stimulation de la thrombopo\u00ef\u00e8se par IL-6 et thrombopo\u00ef\u00e9tine en contexte inflammatoire<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>VPM bas \u2014 orientation diagnostique<\/h2>\n <ul class=\"co-list\">\n <li><strong>Aplasie m\u00e9dullaire :<\/strong> VPM low + pancytopenia + collapsed reticulocytes \u2192 empty marrow \u2192 myelogram essential + treatment: cyclosporine + ALS (anti-lymphocyte serum) + stem cell transplant<\/li>\n <li><strong>My\u00e9lodysplasie :<\/strong> VPM (dysplastic platelets) + macrocytosis + variable cytopenias \u2192 bone marrow biopsy + karyotype \u2192 risk of transformation into AML<\/li>\n <li><strong>Infiltration m\u00e9dullaire (m\u00e9tastases + lymphomes + leuc\u00e9mies) :<\/strong> hematopoietic bone marrow replacement \u2192 thrombocytopenia + low MPV + leucoerythroblastosis on peripheral blood smear (presence of erythroblasts + myelocytes in peripheral blood)<\/li>\n <li><strong>Chimioth\u00e9rapie + radioth\u00e9rapie my\u00e9losuppressive :<\/strong> Direct toxicity to megakaryocytes \u2192 thrombocytopenia + low transient MPV + recovery in 2\u20133 weeks after cessation<\/li>\n <li><strong>Wiskott-Aldrich Syndrome:<\/strong> maladie rare li\u00e9e \u00e0 l'X + microthrombocytes pathognomoniques (VPM tr\u00e8s bas + <5 fl) + ecz\u00e9ma + d\u00e9ficit immunitaire combin\u00e9 + thrombop\u00e9nie s\u00e9v\u00e8re<\/li>\n <li><strong>B12 and folate deficiency<\/strong> Megaloblastic dysthrombopoiesis \u2192 small platelets + dysfunctional + often in context of pancytopenia<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La combinaison thrombop\u00e9nie + VPM \u00e9lev\u00e9 oriente vers une destruction p\u00e9riph\u00e9rique (PTI + CIVD + PTT) avec une moelle r\u00e9active \u2014 dans ce cas, la moelle est fonctionnelle et lib\u00e8re des plaquettes jeunes et grandes en compensation. \u00c0 l'inverse, la combinaison thrombop\u00e9nie + VPM bas oriente vers une insuffisance de production m\u00e9dullaire (aplasie + my\u00e9lodysplasie + infiltration + chimioth\u00e9rapie) \u2014 dans ce cas la moelle est d\u00e9faillante et ne peut pas compenser la thrombop\u00e9nie. Cette distinction oriente directement vers le my\u00e9logramme si VPM bas + thrombop\u00e9nie inexpliqu\u00e9e, versus vers la recherche d'une cause de destruction p\u00e9riph\u00e9rique si VPM \u00e9lev\u00e9.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si une thrombop\u00e9nie est d\u00e9couverte sur la NFS \u2014 qu'elle s'accompagne d'un VPM \u00e9lev\u00e9 (destruction p\u00e9riph\u00e9rique probable) ou d'un VPM bas (insuffisance m\u00e9dullaire probable) + particuli\u00e8rement si le compte plaquettaire est inf\u00e9rieur \u00e0 50 G\/L + ou si des signes h\u00e9morragiques sont pr\u00e9sents (p\u00e9t\u00e9chies + ecchymoses + saignements muqueux). Une thrombop\u00e9nie s\u00e9v\u00e8re (<20 G\/L) avec signes h\u00e9morragiques actifs constitue une urgence m\u00e9dicale. Pour le bilan complet des anomalies plaquettaires et l'interpr\u00e9tation du VPM, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron interpr\u00e8tent le VPM dans le contexte clinique et avec l'ensemble de la NFS, distinguent la thrombop\u00e9nie par destruction p\u00e9riph\u00e9rique (VPM \u00e9lev\u00e9 \u2014 PTI + CIVD) de la thrombop\u00e9nie par insuffisance m\u00e9dullaire (VPM bas \u2014 aplasie + my\u00e9lodysplasie), prescrivent le frottis sanguin pour confirmation + le bilan \u00e9tiologique cibl\u00e9, orientent vers l'h\u00e9matologie pour le my\u00e9logramme si une cause m\u00e9dullaire est suspect\u00e9e, et assurent le suivi des thrombop\u00e9nies chroniques. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un h\u00e9matologue. Le VPM est sujet \u00e0 des variations pr\u00e9analytiques importantes \u2014 les plaquettes gonflent dans l'EDTA avec le temps, augmentant artificiellement le VPM si l'analyse est retard\u00e9e. Un VPM isol\u00e9ment \u00e9lev\u00e9 ou bas sans thrombop\u00e9nie ni autre anomalie de la NFS est rarement cliniquement significatif.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>VPM (volume plaquettaire moyen) : interpr\u00e9tation clinique et causes d’anomalie | Clinique Omicron H\u00e9matologie & Biochimie clinique & M\u00e9decine de famille VPM \u2014 Volume plaquettaire moyen Le volume plaquettaire moyen (VPM) \u2014 d\u00e9sign\u00e9 MPV (Mean Platelet Volume) dans les pays anglophones \u2014 est un param\u00e8tre plaquettaire calcul\u00e9 automatiquement par l’h\u00e9mogramme (NFS) mesurant le volume moyen… <a href=\"https:\/\/cliniqueomicron.ca\/en\/volume-plaquettaire-moyen-vpm\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">MPV (mean platelet volume): clinical interpretation and causes of abnormality | Omicron Clinic<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Volume plaquettaire moyen VPM | Brossard | Clinique Omicron","_metasync_otto_description":"Volume plaquettaire moyen VPM Volume plaquettaire moyen VPM est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test...","_metasync_otto_keywords":"volume plaquettaire moyen vpm, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"","_metasync_otto_og_description":"Volume plaquettaire moyen VPM Volume plaquettaire moyen VPM est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Volume plaquettaire moyen VPM Volume plaquettaire moyen VPM est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"VPM (volume plaquettaire moyen) : interpr\u00e9tation clinique et causes d'anomalie | Clinique Omicron","_aioseo_description":"Le VPM mesure la taille moyenne des plaquettes. VPM \u00e9lev\u00e9 >12.5fl PTI destruction p\u00e9riph\u00e9rique plaquettes jeunes r\u00e9actionnelles, VPM bas <7.5fl aplasie my\u00e9lodysplasie insuffisance m\u00e9dullaire, Wiskott-Aldrich microthrombocytes et bilan au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-04T21:54:44+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-25065","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Volume plaquettaire moyen VPM Volume plaquettaire moyen VPM est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. 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