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Thrombocytopenia is more severe in patients with advanced chronic hepatitis C than B with the same grade of liver stiffness and splenomegaly

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

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.

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Abbreviations

ALT:

Alanine aminotransferase

ANCOVA:

Analysis of covariance

CLD:

Chronic liver disease

HBeAg:

Hepatitis B envelope antigen

HBsAg:

Hepatitis B surface antigen

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

IPF:

Immature platelet fraction

IQR:

Interquartile ranges

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Authors and Affiliations

  1. Department of Clinical Laboratory Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kazuaki Tejima, Hitoshi Ikeda, Yosuke Sugioka, Yukio Kume, Tomoko Okano, Tomomi Iwai, Hiroaki Gotoh, Sachiko Katoh, Atsushi Suzuki, Yukako Koike & Yutaka Yatomi

  2. Department of Gastroenterology, Toshiba General Hospital, 6-3-22 Higashi-ooi, Shinagawa-ku, Tokyo, 140-8522, Japan

    Kazuaki Tejima

  3. Department of Gastroenterology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Ryota Masuzaki, Haruhiko Yoshida, Ryosuke Tateishi, Masao Omata & Kazuhiko Koike

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  1. Kazuaki Tejima
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  2. Ryota Masuzaki
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  3. Hitoshi Ikeda
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  4. Haruhiko Yoshida
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Correspondence to Hitoshi Ikeda.

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Tejima, K., Masuzaki, R., Ikeda, H. et al. Thrombocytopenia is more severe in patients with advanced chronic hepatitis C than B with the same grade of liver stiffness and splenomegaly. J Gastroenterol 45, 876–884 (2010). https://doi.org/10.1007/s00535-010-0233-5

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  • DOI: https://doi.org/10.1007/s00535-010-0233-5

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