Erythrocyte creatine as a marker of excessive erythrocyte destruction due to hypersplenism in patients with liver cirrhosis.
OBJECTIVE
Erythrocyte creatine is a sensitive marker of erythrocyte age, and can be used to detect slight and continuous hemolysis. Excessive blood cell destruction caused by increased spleen function is important evidence of hypersplenism. This study evaluates the usefulness of erythrocyte creatine as a sensitive marker of excessive erythrocyte destruction due to hypersplenism in patients with liver cirrhosis.


METHODS
Erythrocyte creatine was determined by an enzymatic method in 50 patients with postnecrotic liver cirrhosis and 50 healthy controls. The spleen size was measured by ultrasonography and expressed as a spleen index.


RESULTS
The patients with splenomegaly showed significantly higher erythrocyte creatine than those without splenomegaly (p < 0.005) and healthy controls (p < 0.001), but there was no significant difference in erythrocyte creatine between healthy controls and those without splenomegaly. Fourteen (93%) of the 15 patients with abnormally high erythrocyte creatine (> 1.8 micromol/g hemoglobin) had splenomegaly. There were no significant differences in reticulocyte count between healthy controls and the patients with and without splenomegaly. Erythrocyte creatine showed good correlations with spleen index (r = 0.67; p < 0.001) and reticulocytes (r = 0.63; p < 0.001).


CONCLUSIONS
Erythrocyte creatine can be used for predicting erythropoietic status and estimating hypersplenism in patients with liver cirrhosis.
Jiao
Y F
YF
Department of Laboratory Medicine, Kochi Medical School, Nankoku, Japan.
Okumiya
T
T
Saibara
T
T
Kudo
Y
Y
Sugiura
T
T
D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis*; D003401:Creatine / Q000097:blood*; D004905:Erythrocyte Aging; D004912:Erythrocytes / Q000502:physiology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006971:Hypersplenism / Q000175:diagnosis*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D017701:Reticulocyte Count; D013154:Spleen / Q000000981:diagnostic imaging / Q000502:physiology; D013223:Statistics as Topic; D014463:Ultrasonography
D015415:Biomarkers; D006454:Hemoglobins; D003401:Creatine