Thrombocytopenia associated with liver cirrhosis and hepatitis C viral infection: role of thrombopoietin.
OBJECTIVE
Thrombocytopenia in chronic liver diseases has traditionally been considered a consequence of platelet pooling and destruction in spleen. We tried to evaluate the influence of thrombopoietin, the physiological regulator of thrombopoiesis, on the origin of this thrombocytopenia.


METHODS
We determined serum thrombopoietin levels by ELISA in thrombocytopenic patients with liver cirrhosis (n = 32) and with chronic hepatitis C viral infection (n = 23). A group of 43 healthy subjects was used as a control.


RESULTS
Liver cirrhosis patients presented slightly, but not significantly, lower serum thrombopoietin levels (104 +/- 56 pg/mL) than controls (121 +/- 58 pg/mL) or patients infected with chronic hepatitis C virus (125 +/- 40 pg/mL). No correlations were found between serum thrombopoietin concentrations and liver tests or hematological parameters.


CONCLUSIONS
We conclude that low thrombopoietin production may play a role, along with hypersplenism, in the development of thrombocytopenia in patients with liver cirrhosis. Normal thrombopoietin levels exclude a defect in thrombopoietin production as a possible etiology for the thrombocytopenia in patients with chronic hepatitis C viral infection. However, a direct viral megakaryocyte infection or an immune mechanism could explain this thrombocytopenia, according to the thrombopoietin levels detected.
Español
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I
Departament d'Hematologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma, Barcelona, Spain.
Gallego
A
A
Enríquez
J
J
Rabella
N
N
Lerma
E
E
Hernández
A
A
Pujol-Moix
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D006971:Hypersplenism / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000209:etiology*; D013926:Thrombopoietin / Q000097:blood / Q000502:physiology*
D013926:Thrombopoietin