title: Abnormal platelet kinetics are detected before the occurrence of thrombocytopaenia in HBV-related liver disease.
abstract: OBJECTIVE
  Thrombocytopaenia is a frequent feature in patients with HBV-related liver disease. Its underlying mechanism is not fully understood. Multiple factors might contribute to the development of thrombocytopaenia. In this study, we investigated the reticulated platelets (RP), glycocalicin (GC), serum thrombopoietin (TPO) and platelet glycoprotein (GP) in different stages of the disease.
  
  
  METHODS
  One hundred and fourteen patients with HBV-related liver disease (30 with chronic hepatitis B (CHB), 20 patients in Child A without thrombocytopaenia, 19 patients in Child A with thrombocytopaenia, 45 in Child B/C with thrombocytopaenia) and 25 normal controls (NC) were enrolled. Liver cirrhosis (LC) was classified according to modified Child-Turcotte-Pugh (CTP) score. Serum TPO levels and GC were measured by ELISA. RP and platelet glycoprotein (GP) expression were detected by flow cytometry.
  
  
  RESULTS
  The TPO levels of patients with LC were significantly lower than that of controls, even in patients of Child A without thrombocytopaenia group. Serum TPO level was positively correlated (r = 0.65, p < 0.01) with serum albumin in Child B/C group. Both the RP percentages and the glycocalicin index (GCI) levels were significantly higher in patients groups including CHB and Child A without thrombocytopaenia than that of normal controls. A negative correlation existed in HBV DNA copies and the GPs% in patients with CHB and Child A without thrombocytopaenia.
  
  
  CONCLUSIONS
  Abnormal platelet production, destruction and platelet-specific glycoproteins levels were detected before the occurrence of thrombocytopaenia in HBV-related liver disease, indicating that multiple mechanisms might play roles in thrombocytopaenia in HBV-infected patients.
authors.affiliation: Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Gastroenterology, Wuxi Second People's Hospital, Jiangsu Province, China; Department of Gastroenterology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.forename: Fanli
authors.initials: F
authors.lastname: Hua
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Zhan
authors.forename: Yingying
authors.initials: Y
authors.lastname: Li
authors.forename: Lili
authors.initials: L
authors.lastname: Ji
authors.forename: Shanhua
authors.initials: S
authors.lastname: Zou
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Min
authors.forename: Dongli
authors.initials: D
authors.lastname: Song
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Cheng
mesh_terms: D001792:Blood Platelets / Q000166:cytology*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005434:Flow Cytometry; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000378:metabolism*; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism*; D013921:Thrombocytopenia / Q000209:etiology* / Q000378:metabolism*; D013926:Thrombopoietin / Q000097:blood*
chemical_list: D019038:Platelet Glycoprotein GPIb-IX Complex; D010980:Platelet Membrane Glycoproteins; C023592:glycocalicin; D013926:Thrombopoietin
keywords: Cirrhosis; HBV; glycocalicin; platelet kinetics; reticulated platelet; thrombopoietin