Factors associated with the platelet count in patients with chronic hepatitis C
| Autor: | Michele M. Tana, Theo Heller, David E. Kleiner, Elenita Rivera, Sandra Page, Mi Sun Moon, Xiongce Zhao, Tiffany Turner, Alyson Bradshaw |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Blood Platelets Liver Cirrhosis Male medicine.medical_specialty P-selectin Hepatitis C virus Biopsy medicine.disease_cause Gastroenterology Article Von Willebrand factor hemic and lymphatic diseases Diabetes mellitus Internal medicine von Willebrand Factor medicine Humans Platelet Retrospective Studies biology business.industry Platelet Count Platelet Glycoprotein GPIb-IX Complex Hematology Hepatitis C Organ Size Hepatitis C Chronic Middle Aged medicine.disease Fibrosis P-Selectin Cross-Sectional Studies Liver Thrombopoietin Immunoglobulin G Immunology biology.protein Female Transient elastography business Spleen |
| Zdroj: | Thrombosis research. 135(5) |
| ISSN: | 1879-2472 |
| Popis: | There are many potential causes of thrombocytopenia in patients with chronic hepatitis C (CHC).We sought to determine the association between thrombopoietin (TPO) level, immature platelet fraction (IPF), immunoglobulin G (IgG) level, spleen size, and the platelet count in CHC.We studied a consecutive sample of patients enrolled in an observational study at a referral-based research center, excluding subjects based on eligibility criteria. TPO, glycocalicin, and von Willebrand Factor (vWF) levels were determined using stored sera. Hepatic fibrosis was assessed via transient elastography (TE) when available, and clinical laboratory values and radiologic data were obtained from the medical record. We performed analyses of the relationships between independent variables and the platelet count.On univariate analysis, the following variables were significantly associated with the platelet count: age, alanine aminotransferase (ALT), direct bilirubin, total bilirubin, IPF, international normalized ratio (INR), spleen size, vWF, glycocalicin, fibrosis stage on liver biopsy, and TE (P-values all0.05). A multivariable model determined that imputed TE score, TPO, IPF, and spleen size were independently associated with the platelet count (P-values all0.05).The platelet count in CHC is significantly associated with fibrosis, TPO level, IPF, and spleen size. Our findings challenge the proposed mechanism of decreased TPO levels or decreased bone marrow production of platelets as a cause of thrombocytopenia in CHC. Future studies focusing on the effects of fibrosis and splenomegaly on platelets may shed more light on the pathophysiology of thrombocytopenia in patients with CHC. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect