Changes of Peripheral Blood Cells in Patients with Cirrhotic Portal Hypertension

Lv, Yunfu

doi:10.5772/38814

Cited by 2 publications

(2 citation statements)

References 23 publications

(22 reference statements)

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“…The more the types of blood cells are involved, the more severe is the disease and the worse is the prognosis. 32 The spleen is the target organ in hypersplenism. If peripheral cytopenia is caused by hypersplenism, the blood cells should return to normal after splenectomy.…”

Section: Discussionmentioning

confidence: 99%

Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly

Lau

et al. 2017

Exp Biol Med (Maywood)

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Impact statementFor a long time, the development of peripheral cytopenias as a complication to cirrhotic portal hypertension has been attributed to hypersplenism; however, this has never been fully demonstrated. Dameshek summarized that hypersplenism should be diagnosed by the presence of four conditions: (a) mono-or multi-lineage peripheral cytopenias; (b) compensatory hyperplasia of bone marrow; (c) splenomegaly; and (d) correction of cytopenias after splenectomy. We retrospectively analyzed the clinical data from 183 surgical patients, and found that 80.5% of peripheral cytopenias was caused by hypersplenism, 16% by a combination of factors, and 3.5% by other factors unrelated to hypersplenism. As the first quantitative findings in this field, our results verify that hypersplenism is a major, but not exclusive, cause of peripheral cytopenias, and provides important clinical evidence for investigating the cause of peripheral cytopenias. AbstractThe clinical data of 183 patients with hepatitic cirrhosis and portal hypertensive splenomegaly complicated by peripheral cytopenia were retrospectively analyzed to investigate the causes of peripheral cytopenia, as well as the proportion of the causes in these patients. All patients underwent splenectomy. Before operation, these patients had one or more types of peripheral cytopenia (cumulative cytopenia: 390 patient-times). After splenectomy, blood counts in 79.2% (309/390) returned to normal, while in 15.9% (62/390) they increased but failed to reach to normal levels, and in 4.9% (19/390) they became lower than before the operations. For the last group of patients (n ¼ 19), long-term follow-up showed that blood counts returned to normal in five patients. In other words, in 80.5% [(309 þ 5)/390 or 314/ 390] of patient-times, the peripheral cytopenia was due to hypersplenism, in 15.9% it was due to a combination of factors, and in 3.6% [14/390] it had nothing to do with the hypersplenism. Thus, hypersplenism is a major cause, but not the only cause, of peripheral cytopenia in patients with hepatic cirrhosis and portal hypertensive splenomegaly, and splenectormy is an effective treatment for these patients.

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Section: Discussionmentioning

confidence: 99%

Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly

Lau

et al. 2017

Exp Biol Med (Maywood)

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“…In recent years, the number of patients with cirrhotic portal hypertension that require surgery has decreased significantly. However, in patients with cirrhotic portal hypertension, 35% of cases have ≤ 50,000 platelets in blood circulation, 40% of cases have a history of upper gastrointestinal hemorrhage, [2] and 18-23% of cases are complicated by liver cancer [3,4]. The majority of these patients requires surgery, with a goal of staunching bleeding, eliminating splenomegaly and severe hypersplenism (hereinafter referred to as hypersplenism), and resecting liver tumors; however the surgical risks are great and the mortality rates are high.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Risk Factors for Surgery in Patients with Cirrhotic Portal Hypertension

Lv¹,

Lau²,

Han³

et al. 2014

J Hypertens

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This study excluded patients with non-cirrhotic portal hypertension, such as regional portal hypertension, patients with no evidence of splenomegaly or hematocytopenia of one or multiple cell lines in the circulatory blood. Clinical data Of the 161 patients enrolled, 97 were male and 64 female (male: female=1.5:1). The ages of patients ranged from 10 to 64 years and averaged 42 years. One hundred twenty-two patients had liver cirrhosis secondary to HBV-hepatitis, 26 patients had liver cirrhosis secondary to HCV-hepatitis, 5 had biliary cirrhosis, 3 had alcoholic cirrhosis, 2

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Changes of Peripheral Blood Cells in Patients with Cirrhotic Portal Hypertension

Cited by 2 publications

References 23 publications

Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly

Causes of peripheral cytopenia in hepatitic cirrhosis and portal hypertensive splenomegaly

Prognostic Risk Factors for Surgery in Patients with Cirrhotic Portal Hypertension

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