LETTER TO THE EDITOR

Mean platelet volume in patients with varicocele doi: 10.1111/and.12277

We read with interest the article entitled ‘Is there any relationship between mean platelet volume (MPV) and varicocele?’ by Coban et al. (2014). In that very welldesigned and presented study, the coworkers tried to evaluate the relationship between the presence of varicocele and the MPV, platelet count and platelet distribution width values. They concluded that MPV values were significantly high, whereas PLT and PDW values were statistically significantly low in the varicocele group compared with the control group. The ready availability of MPV measurements at no additional cost may encourage its wider use in clinical practice. A complete blood count is a relatively routine, inexpensive, practical and easy examination that supplies additional information. MPV is a widely used laboratory marker associated with platelet function based on inflammatory conditions (Balta et al., 2013a). The MPV also indicates platelet function, which is central to processes that are involved in coronary heart disease pathophysiology and endothelial dysfunction. Recently, increased levels of MPV were demonstrated in atrial fibrillation (Balta et al., 2013b), cerebrovascular disease, peripheral artery disease, stroke, malignancy, ulcerative colitis and coeliac disease, all of that are related to endothelial dysfunction on the basis of inflammation (Demirkol et al., 2012). The higher MPV values are considered to be a useful indicator of higher thromboycte activity and have been found to be associated with inflammation in patients with thyroid and rheumatic diseases. Some inflammatory disease such as Behcßet’s disease (BD) is a chronic, systemic vasculitis, which may affect all types and sizes of blood vessels. BD is associated with endothelial dysfunction and chronic inflammation. We previously showed that MPV levels were significantly higher in patients with BD compared with control group (Balta et al., 2013c), Therefore, it may be interesting if the authors provided information about these conditions. It is very important that the MPV increases over time in EDTA-anticoagulated samples. Because they evaluated patients retrospectively, they cannot accurately define how much time elapsed before measuring MPV levels; delaying blood sampling may lead to abnormal results in MPV measurements (Ekiz et al., 2014). Finally, not only MPV but also red cell distribution width (Balta et al., 2013d), neutrophil lymphocyte ratio (Cingoz et al., 2013), plateletcrit (PCT), platelet lymphocyte ratio, CRP, ferritin and uric acid are easy methods to

© 2015 Blackwell Verlag GmbH Andrologia 2015, 47, 365–366

evaluate the varicocele pathophysiology and the relevant vascular pathologies (Balta et al., 2013a). These markers might be useful in clinical practice (Demirkol et al., 2014). In conclusion, we believe that the findings of the current study will lead to further studies examining the relationship between MPV and varicocele. However, MPV itself alone without other inflammatory indicators may not provide enough information about the varicocele pathophysiology and the relevant vascular pathologies. S. Balta Department of Cardiology, Eskisßehir Military Hospital, Eskisßehir, Turkey e-mail: [email protected] M. Demir, S. Demirkol, C. Ozturk & T. Celik Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey References Balta S, Demirkol S, Kucuk U, Unlu M (2013a) Hemostatic markers can be pivotal roles of risk factors for new-onset atrial fibrillation. Platelets doi:10.3109/09537104.2013.778398 [Epub ahead of print]. Balta S, Demirkol S, Unlu M, Celik T (2013b) Other inflammatory markers should be kept in mind when assessing the mean platelet volume. Platelets doi:10.3109/09537104.2013. 775643 [Epub ahead of print]. Balta I, Balta S, Koryurek OM, Demirkol S, Celik T, Akbay G, Cakar M, Sarlak H, Eksioglu M (2013c) Mean platelet volume is associated with aortic arterial stiffness in patients with Behcßet’s disease without significant cardiovascular involvement. J Eur Acad Dermatol Venereol doi:10.1111/jdv. 12297 [Epub ahead of print]. Balta S, Demirkol S, Celik T, Kucuk U, Unlu M, Arslan Z, Balta I, Iyisoy A, Kocak N, Haqmal H, Yokusoglu M (2013d) Association between coronary artery ectasia and neutrophil-lymphocyte ratio. Angiology 64:627–632. Cingoz F, Iyisoy A, Demirkol S, Sahin MA, Balta S, Celik T, Unlu M, Arslan Z, Cakar M, Kucuk U, Demirbas S, Kocak N (2013) Carotid intima-media thickness in patients with slow coronary flow and its association with neutrophil-tolymphocyte ratio: a preliminary report. Clin Appl Thromb Hemost [Epub ahead of print]. € unay Coban S, Keles I, Biyik I, G€ uzelsoy M, T€ urkoglu AR, Ozg€ T, Ocak N (2014) Is there any relationship between mean platelet volume and varicocele? Andrologia 47:37–41. Demirkol S, Balta S, Unlu M, Yuksel UC, Celikk T, Arslan Z, Kucuk U, Yokusoglu M (2012) Evaluation of the mean

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platelet volume in patients with cardiac syndrome X. Clinics (S~ao Paulo) 67:1019–1022. Demirkol S, Balta S, Unlu M, Arslan Z, Cakar M, Kucuk U, Celik T, Arslan E, Turker T, Iyisoy A, Yokusoglu M (2014) Neutrophils/lymphocytes ratio in patients with cardiac

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syndrome X and its association with carotid intima-media thickness. Clin Appl Thromb Hemost 20:250–255. Ekiz O, Balta I, Sen BB, Rifaioglu EN, Ergin C, Balta S, Demirkol S (2014) Mean platelet volume in recurrent aphthous stomatitis and Behcet disease. Angiology 65:161–165.

© 2015 Blackwell Verlag GmbH Andrologia 2015, 47, 365–366

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Mean platelet volume in patients with varicocele.

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