Journal of Gastroenterology

, Volume 45, Issue 8, pp 876–884 | Cite as

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

  • Kazuaki Tejima
  • Ryota Masuzaki
  • Hitoshi Ikeda
  • Haruhiko Yoshida
  • Ryosuke Tateishi
  • Yosuke Sugioka
  • Yukio Kume
  • Tomoko Okano
  • Tomomi Iwai
  • Hiroaki Gotoh
  • Sachiko Katoh
  • Atsushi Suzuki
  • Yukako Koike
  • Yutaka Yatomi
  • Masao Omata
  • Kazuhiko Koike
Original Article—Liver, Pancreas, and Biliary Tract

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.

Keywords

Liver stiffness Splenomegaly Thrombocytopenia Thrombopoietin Transient elastography 

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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Copyright information

© Springer 2010

Authors and Affiliations

  • Kazuaki Tejima
    • 1
    • 2
  • Ryota Masuzaki
    • 3
  • Hitoshi Ikeda
    • 1
  • Haruhiko Yoshida
    • 3
  • Ryosuke Tateishi
    • 3
  • Yosuke Sugioka
    • 1
  • Yukio Kume
    • 1
  • Tomoko Okano
    • 1
  • Tomomi Iwai
    • 1
  • Hiroaki Gotoh
    • 1
  • Sachiko Katoh
    • 1
  • Atsushi Suzuki
    • 1
  • Yukako Koike
    • 1
  • Yutaka Yatomi
    • 1
  • Masao Omata
    • 3
  • Kazuhiko Koike
    • 3
  1. 1.Department of Clinical Laboratory MedicineThe University of TokyoBunkyo-kuJapan
  2. 2.Department of GastroenterologyToshiba General HospitalShinagawa-kuJapan
  3. 3.Department of GastroenterologyThe University of TokyoBunkyo-kuJapan

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