Effect of splenectomy on platelets associated antibodies in hepatitis C patients with thrombocytopenia.
BACKGROUND
This study aimed to assess the role of splenomegaly as a source of platelet-associated immunoglobulins (PAIgs) in thrombocytopenic patients with chronic hepatitis C virus (HCV) infection.


METHODS
The present study was conducted on 63 subjects categorized as follows. Group 1: Included 63 cases diagnosed as patients with HCV liver cirrhosis combined with thrombocytopenia before splenectomy. Group 2: Included the same 63 cases one week after splenectomy. For all subjects included in this study platelets counts were evaluated as well as PAIgs (total Igs, IgG, IgM, and IgA).


RESULTS
All patients were thrombocytopenic before undergoing splenectomy (platelet counts [median 68.5; range 44-95]). After splenectomy all patients achieved normal platelet counts (median 180; range 108-235). The mean ± SD of PAIgs was 64.2 ± 9.6 for total IgG, 53.6 ± 8.1 for IgG, 3.8 ± 2.1 for IgM, 6.7 ± 4.7 for IgA presplenectomy versus postsplenectomy 13.4 ± 19.3 for total Igs, 5.4 ± 1.8 for IgG, 1.9 ± 1.06 for IgM, 2.1 ± 0.9 for IgA, and the differences between pre and postsplenectomy figures were statistically significant (P < 0.001). The correlation studies between platelet count and PAIgs level in patients with chronic HCV infection presplenectomy revealed that there is significant negative correlation between platelet counts and all immunoglobulins (total Igs: r - 0.804, P = 0.000; IgG: r - 0.907, P = 0.000; IgM: r - 0.467, P = 0.002; and IgA: r - 0.519, P = 0.000).


CONCLUSIONS
Autoimmune mechanism plays an important role in the HCV-associated thrombocytopenia and spleen is a major source of PAIgs.
Hematology Unit, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt. salaharef@yahoo.com
Salah
S
Aref
Lamyaa
L
Ibrahem
Nadia
N
El Menshawy
Ansaf
A
Bassam
D000328:Adult; D015551:Autoimmunity; D001792:Blood Platelets / Q000276:immunology* / Q000473:pathology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology* / Q000821:virology; D006801:Humans; D007136:Immunoglobulins / Q000097:blood / Q000276:immunology*; D008103:Liver Cirrhosis / Q000150:complications / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013154:Spleen / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D013156:Splenectomy; D013163:Splenomegaly / Q000150:complications / Q000276:immunology* / Q000821:virology; D013921:Thrombocytopenia / Q000150:complications / Q000276:immunology* / Q000821:virology
D007136:Immunoglobulins