Literature DB >> 16534872

Autoimmune thrombocytopenia in response to splenectomy in cirrhotic patients with accompanying hepatitis C.

Tetsuro Sekiguchi1, Takeaki Nagamine, Hitoshi Takagi, Masatomo Mori.   

Abstract

AIM: To estimate the contribution of autoimmune thrombocytopenia to hepatitis C virus-related liver cirrhosis (type C cirrhosis), we evaluated the influence of splenectomy upon platelet-associated immunoglobulin G (PAIgG) levels and platelet numbers.
METHODS: PAIgG titers and immune markers were determined in 24 type C cirrhotic patients with an intact spleen, 17 type C cirrhotic patients submitted to splenectomy, and 21 non-C cirrhosis with an intact spleen.
RESULTS: Thrombocytopenia (PLT < 15 x 10(4)/microL) in type C cirrhosis was diagnosed in all patients with an intact spleen, 8 patients submitted to splenectomy, and in 19 non-C cirrhosis with intact spleen. Elevated titers of PAIgG at more than 25.0 ng/10(7) cells were detected in all cirrhotic patients except for one splenectomized patient. PAIgG titers (ng/10(7) cells) were significantly higher in the type C cirrhosis with an intact spleen (247.9+/-197.0) compared with the splenectomized patients (125.6+/-87.8) or non-C cirrhosis (152.4+/-127.4). PAIgG titers were negatively correlated with platelet counts in type C cirrhotic patients with an intact spleen. In comparison with the type C cirrhosis with an intact spleen, the splenectomized patients had a reduced CD4/CD8 ratio and serum neopterin levels. The spleen index (cm2) was negatively correlated with platelet counts in the non-C cirrhosis, but not in the type C cirrhosis.
CONCLUSION: Our data indicate that the autoimmune mechanism plays an important role in thrombocytosis complicated by HCV-positive cirrhosis. In addition, splenectomy may impair T cells function through, at least in part, a reduction of CD4/CD8 ratio, consequently suppressing PAIgG production.

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Year:  2006        PMID: 16534872      PMCID: PMC4124430          DOI: 10.3748/wjg.v12.i8.1205

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


  34 in total

Review 1.  Natural history of chronic hepatitis C.

Authors:  Leonard B Seeff
Journal:  Hepatology       Date:  2002-11       Impact factor: 17.425

2.  Pooling of platelets in the spleen: role in the pathogenesis of "hypersplenic" thrombocytopenia.

Authors:  R H Aster
Journal:  J Clin Invest       Date:  1966-05       Impact factor: 14.808

3.  Correlation between serum IgG, platelet membrane IgG, and platelet function in hypergammaglobulinaemic states.

Authors:  K M McGrath; J J Stuart; F Richards
Journal:  Br J Haematol       Date:  1979-08       Impact factor: 6.998

4.  Thrombopoietin (TPO) levels in hepatic patients with thrombocytopenia.

Authors:  Salah Aref; M Mabed; T Selim; T Goda; N Khafagy
Journal:  Hematology       Date:  2004 Oct-Dec       Impact factor: 2.269

5.  Differentiation of autoimmune thrombocytopenia from thrombocytopenia associated with immune complex disease: systemic lupus erythematosus, hepatitis-cirrhosis, and HIV-1 infection by platelet and serum immunological measurements.

Authors:  H Samuel; M Nardi; M Karpatkin; D Hart; M Belmont; S Karpatkin
Journal:  Br J Haematol       Date:  1999-06       Impact factor: 6.998

6.  The clinical significance of platelet-associated IgG: a study on 298 patients with various disorders.

Authors:  C Mueller-Eckhardt; W Kayser; K Mersch-Baumert; G Mueller-Eckhardt; M Breidenbach; H G Kugel; M Graubner
Journal:  Br J Haematol       Date:  1980-09       Impact factor: 6.998

7.  Mimicry between the hepatitis C virus polyprotein and antigenic targets of nuclear and smooth muscle antibodies in chronic hepatitis C virus infection.

Authors:  G V Gregorio; K Choudhuri; Y Ma; P Pensati; R Iorio; P Grant; J Garson; D P Bogdanos; A Vegnente; G Mieli-Vergani; D Vergani
Journal:  Clin Exp Immunol       Date:  2003-09       Impact factor: 4.330

8.  Role of elevated platelet-associated immunoglobulin G and hypersplenism in thrombocytopenia of chronic liver diseases.

Authors:  Akira Sanjo; Jujin Satoi; Akihiro Ohnishi; Junko Maruno; Masayuki Fukata; Naoki Suzuki
Journal:  J Gastroenterol Hepatol       Date:  2003-06       Impact factor: 4.029

9.  Immune thrombocytopenia. Use of a Coombs antiglobulin test to detect IgG and C3 on platelets.

Authors:  D B Cines; A D Schreiber
Journal:  N Engl J Med       Date:  1979-01-18       Impact factor: 91.245

10.  Platelet-associated IgG in immune thrombocytopenic purpura.

Authors:  G A Luiken; R McMillan; A L Lightsey; P Gordon; S Zevely; I Schulman; T J Gribble; R L Longmire
Journal:  Blood       Date:  1977-08       Impact factor: 22.113

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