title: Prevalence of peripheral blood cytopenias (hypersplenism) in patients with nonalcoholic chronic liver disease.
abstract: OBJECTIVE
  Thrombocytopenia or leukopenia in patients with chronic liver disease is often attributed to functional overactivity of the spleen (hypersplenism). Despite being a fairly common phenomenon, there is a paucity of reports on the prevalence of this syndrome in stable chronic liver disease patients with or without severe fibrosis/cirrhosis. The aim of this study was to establish the prevalence of peripheral blood cytopenia in patients with nonalcoholic cirrhosis/severe fibrosis versus patients with mild or no fibrosis on liver biopsy.
  
  
  METHODS
  This is a retrospective chart review of 235 patients who underwent a liver biopsy. One hundred ninety-one patients met strict criteria for study entry; 28 different clinical and laboratory variables were collected from their charts review, and data were then analyzed using the SPSS statistical package.
  
  
  RESULTS
  Of the cirrhotic patients, 64% were noted to have platelet counts consistently below 150,000 (lower limit of normal in our laboratory; mean, 144.6 +/- 89.4; median, 114), whereas only 5.5% of noncirrhotic patients had thrombocytopenia (mean, 252.2 +/- 103.4; median, 238). Leukopenia (WBC, <3,500) was relatively rare in the cirrhotic/fibrotic group, having a prevalence of 5% (7.59 +/- 4.3) versus 3.3% (10.62 +/- 14.2) of noncirrhotic patients.
  
  
  CONCLUSIONS
  Of the patients with cirrhosis, 64% had thrombocytopenia (platelet count, <150,000). The likelihood ratio of finding a platelet count of <100,000 in patients with cirrhosis, as opposed to patients without cirrhosis, is almost 12.
authors.affiliation: Division of Gastroenterology, Metro Health Medical Center, Case Western Reserve University, Cleveland, Ohio 44109, USA.
authors.forename: F N
authors.initials: FN
authors.lastname: Bashour
authors.forename: J C
authors.initials: JC
authors.lastname: Teran
authors.forename: K D
authors.initials: KD
authors.lastname: Mullen
mesh_terms: D001707:Biopsy, Needle; D001772:Blood Cell Count; D006400:Hematocrit; D006801:Humans; D006971:Hypersplenism / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D007958:Leukocyte Count; D007970:Leukopenia / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D010976:Platelet Count; D013921:Thrombocytopenia / Q000097:blood / Q000175:diagnosis* / Q000473:pathology