Thrombopoietin serum levels are elevated in patients with hepatitis B/C infection compared to other causes of chronic liver disease.
OBJECTIVE
Thrombocytopenia in patients with advanced liver disease may stem from a deficient hepatic thrombopoietin production.


METHODS
We determined the relationship between thrombopoietin, thrombocytopenia, aetiology and extent of liver damage by incorporating serum thrombopoietin measurements in the pretransplant evaluation of 111 patients with liver disease.


RESULTS
The extent of thrombocytopenia was related to the underlying cause of disease. The platelet count directly correlated with factor V, II, fibrinogen, and PTT, and a negative correlation was found for splenic size and Child's stage. The thrombopoietin concentrations were age-dependent, and no significant difference resulted between the median thrombopoietin level of liver disease patients with age-matched healthy controls. Thrombopoietin concentrations and platelet counts were not correlated. Although noncirrhotic patients had higher platelet counts than those with Child's A-C cirrhosis (p < 0.001, U-test), no such difference was found in thrombopoietin levels. Patients with hepatitis B and/or C had lower platelet counts compared to patients with nonviral diseases (p < 0.001), and their median thrombopoietin concentrations were significantly higher (p < 0.001).


CONCLUSIONS
We conclude that thrombocytopenia in patients with liver disease is unlikely to be explained only based on a deficient hepatic production of thrombopoietin. Patients with chronic viral hepatitis have significantly elevated thrombopoietin levels; the involved pathomechanisms require further study.
Schöffski
Patrick
P
Department of Hematology/Oncology, Hannover Medical School, Carl-Neuberg-Strasse 1, Germany. Schoeffski.Patrick@MH-Hannover.de
Tacke
Frank
F
Trautwein
Christian
C
Martin
Michael Uwe
MU
Caselitz
Martin
M
Hecker
Hartmut
H
Manns
Michael Peter
MP
Ganser
Arnold
A
D000328:Adult; D002908:Chronic Disease; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology / Q000473:pathology; D013926:Thrombopoietin / Q000097:blood*
D013926:Thrombopoietin