BACKGROUND AND AIM: The mechanism responsible for thrombocytopenia in chronic liver diseases (CLD) is not yet fully understood. The prevalence of thrombocytopenia has been reported to be higher in patients with hepatitis C virus-related hepatocellular carcinoma (CLD-C) than in those with hepatitis B virus-related hepatocellular carcinoma (CDC-B). We have examined the potential difference in thrombocytopenia between patients with CLD-B and those with CLD-C in terms of liver fibrosis adjustment and splenomegaly. METHODS: The study cohort consisted of 102 patients with CLD-B and 143 patients with CLD-C were enrolled. Liver stiffness, which is reported to be well correlated with the degree of liver fibrosis, was measured by transient elastography. RESULTS: The analysis of covariance with liver stiffness as a covariate revealed that the platelet count was lower in CLD-C patients than in CLD-B patients. Following stratification for liver stiffness, thrombocytopenia was found to be more severe in CLD-C patients than CLD-B patients with advanced liver stiffness, whereas the degree of splenomegaly was not significantly different. The plasma thrombopoietin level was not different between CLD-B and CLD-C patients with advanced liver stiffness, and the immature platelet number was lower in CLD-C patients despite thrombocytopenia being more severe in these patients. CONCLUSIONS: CLD-C patients with advanced liver stiffness presented with more severe levels of thrombocytopenia than CLD-B patients even with the same grade of splenomegaly. Impaired platelet production rather than enhanced platelet destruction may underlie the mechanism responsible for thrombocytopenia in patients with CLD.
BACKGROUND AND AIM: The mechanism responsible for thrombocytopenia in chronic liver diseases (CLD) is not yet fully understood. The prevalence of thrombocytopenia has been reported to be higher in patients with hepatitis C virus-related hepatocellular carcinoma (CLD-C) than in those with hepatitis B virus-related hepatocellular carcinoma (CDC-B). We have examined the potential difference in thrombocytopenia between patients with CLD-B and those with CLD-C in terms of liver fibrosis adjustment and splenomegaly. METHODS: The study cohort consisted of 102 patients with CLD-B and 143 patients with CLD-C were enrolled. Liver stiffness, which is reported to be well correlated with the degree of liver fibrosis, was measured by transient elastography. RESULTS: The analysis of covariance with liver stiffness as a covariate revealed that the platelet count was lower in CLD-Cpatients than in CLD-B patients. Following stratification for liver stiffness, thrombocytopenia was found to be more severe in CLD-Cpatients than CLD-B patients with advanced liver stiffness, whereas the degree of splenomegaly was not significantly different. The plasma thrombopoietin level was not different between CLD-B and CLD-Cpatients with advanced liver stiffness, and the immature platelet number was lower in CLD-Cpatients despite thrombocytopenia being more severe in these patients. CONCLUSIONS:CLD-Cpatients with advanced liver stiffness presented with more severe levels of thrombocytopenia than CLD-B patients even with the same grade of splenomegaly. Impaired platelet production rather than enhanced platelet destruction may underlie the mechanism responsible for thrombocytopenia in patients with CLD.
Authors: T Kawasaki; A Takeshita; K Souda; Y Kobayashi; M Kikuyama; F Suzuki; F Kageyama; Y Sasada; E Shimizu; G Murohisa; S Koide; T Yoshimi; H Nakamura; R Ohno Journal: Am J Gastroenterol Date: 1999-07 Impact factor: 10.864
Authors: L E Adinolfi; M G Giordano; A Andreana; M F Tripodi; R Utili; G Cesaro; E Ragone; E Durante Mangoni; G Ruggiero Journal: Br J Haematol Date: 2001-06 Impact factor: 6.998
Authors: Quirino Lai; Alessandro Vitale; Tommaso M Manzia; Francesco G Foschi; Giovanni B Levi Sandri; Martina Gambato; Fabio Melandro; Francesco P Russo; Luca Miele; Luca Viganò; Patrizia Burra; Edoardo G Giannini Journal: Cancers (Basel) Date: 2019-10-15 Impact factor: 6.639