Effect of Splemegaly and Platelet Associated IgG on Thrombocytopenia in Patients with Chronic Liver Disease

Park, Byung Chae; Han, Byung Hoon; Lim, Jin Hyung; Kim, Ji Hyun; Lee, Chel Hee; Chung, Hyo Gyun

Abstract

BACKGROUND AND AIMS: Thrombocytopenia is frequently found in patients with chronic liver disease. The mechanism of thrombocytopenia has been attributed to hypersplenism. Recently, several reports have shown that platelet associated IgG (PA-IgG), which has been thought to be closely related to idiopathic thrombocytopenic purpura (ITP), may play a role in the pathogenesis of thrombocytopenia in patients with chronic liver disease. The aim of this study was to elucidate the prevalance of PA-IgG and to evaluate the effect of splenomegaly and PA-IgG on thrombocytopenia in patients with chronic liver disease.
METHODS
The 125 patients with chronic liver disease (31 chronic hepatitis, 44 liver cirrhosis, 50 hepatocellular carcinoma) were studied. The prevalance of PA-IgG was checked using direct platelet immunofluorescent test. Spleen index was obtained by multiplying the long axis by short axis (cm2).
RESULTS
The prevalance of PA-IgG increased gradually according to the severity of liver disease, and was significantily higher in patients with hepatocellular carcinoma (44.0%) than in patients with chronic hepatitis (6.5%) or liver cirrhosis (18.2%)(p<0.001, p<0.01, respectively). For all patients groups platelet count in PA- IgG positive poup was not significantly different from that in PA-IgG negative group. Noticeably, there was a significant correlation between platelet count and spleen index (r=-0.36, p<0.0001).
CONCLUSIONS
The prevalance of PA-IgG increased gradually according to the severity of liver disease form chronic hepatitis to hepatocellular carcinoma. Spleen enlargement showed important roles in thrombocytopenia, but PA-IgG had no effect on platelet count.