Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly
| Autor: | Yejuan Li, Wan Yee Lau, Qingqing Li, Xiaoyu Han, Jie Yue, Ning Liu, Hongfei Wu, Jie Deng, Xiaoguang Gong, Yunfu Lv |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Adolescent Gastroenterology General Biochemistry Genetics and Molecular Biology Leukocyte Count Young Adult 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine Hypertension Portal Humans Medicine Original Research Aged Retrospective Studies Cytopenia Platelet Count business.industry Anemia Leukopenia Middle Aged medicine.disease Thrombocytopenia Peripheral 030220 oncology & carcinogenesis Splenomegaly Erythrocyte Count Splenectomy Portal hypertension Female 030211 gastroenterology & hepatology business |
| Zdroj: | Experimental Biology and Medicine. 242:744-749 |
| ISSN: | 1535-3699 1535-3702 |
| DOI: | 10.1177/1535370217693113 |
| Popis: | The clinical data of 183 patients with hepatitic cirrhosis and portal hypertensive splenomegaly complicated by peripheral cytopenia were retrospectively analyzed to investigate the causes of peripheral cytopenia, as well as the proportion of the causes in these patients. All patients underwent splenectomy. Before operation, these patients had one or more types of peripheral cytopenia (cumulative cytopenia: 390 patient-times). After splenectomy, blood counts in 79.2% (309/390) returned to normal, while in 15.9% (62/390) they increased but failed to reach to normal levels, and in 4.9% (19/390) they became lower than before the operations. For the last group of patients ( n = 19), long-term follow-up showed that blood counts returned to normal in five patients. In other words, in 80.5% [(309 + 5)/390 or 314/390] of patient-times, the peripheral cytopenia was due to hypersplenism, in 15.9% it was due to a combination of factors, and in 3.6% [14/390] it had nothing to do with the hypersplenism. Thus, hypersplenism is a major cause, but not the only cause, of peripheral cytopenia in patients with hepatic cirrhosis and portal hypertensive splenomegaly, and splenectormy is an effective treatment for these patients.Impact statementFor a long time, the development of peripheral cytopenias as a complication to cirrhotic portal hypertension has been attributed to hypersplenism; however, this has never been fully demonstrated. Dameshek summarized that hypersplenism should be diagnosed by the presence of four conditions: (a) mono- or multi-lineage peripheral cytopenias; (b) compensatory hyperplasia of bone marrow; (c) splenomegaly; and (d) correction of cytopenias after splenectomy. We retrospectively analyzed the clinical data from 183 surgical patients, and found that 80.5% of peripheral cytopenias was caused by hypersplenism, 16% by a combination of factors, and 3.5% by other factors unrelated to hypersplenism. As the first quantitative findings in this field, our results verify that hypersplenism is a major, but not exclusive, cause of peripheral cytopenias, and provides important clinical evidence for investigating the cause of peripheral cytopenias. |
| Databáze: | OpenAIRE |
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