Normal platelet count and leukocytosis findings in chronic liver disease patient with portal hypertension: a rare case

Felicity Pheeyen Marthadinata; Ketut Suryana

doi:10.18203/2320-6012.ijrms20231410

Authors

Felicity Pheeyen Marthadinata Department of Internal Medicine, Wangaya Hospital, Denpasar, Bali, Indonesia
Ketut Suryana Department of Internal Medicine, Merpati Clinic, HIV and Allergy-Clinical Immunology Services Unit, Wangaya Hospital, Denpasar, Bali, Indonesia https://orcid.org/0000-0003-4465-1705

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231410

Keywords:

CLD, Portal hypertensive gastropathy, Hypersplenism, Leukocytosis, Normal platelet

Abstract

Haematologic abnormalities are commonly encountered in chronic liver disease (CLD) due to hypersplenism occurred. Hypersplenism in CLD is a major cause of peripheral pancytopenia in patients with hepatic cirrhosis and portal hypertensive gastropathy and is characterized by splenomegaly. Peripheral pancytopenia is defined as a reduction in all three major constituents of the blood to below lower normal range, manifesting as anemia, leukopenia, and thrombocytopenia all occurring at the same time. We report an unusual case, a 44-year-old female patient, no splenomegaly, presented with severe anemia, leukocytosis and normal platelet which are rarely found in CLD.

Keywords : chronic liver disease, portal hypertensive gastropathy, hypersplenism, leukocytosis, normal platelet

Metrics

Metrics Loading ...

References

Bashour FN, Teran JC, Mullen KD. Prevalence of peripheral blood cytopenias (hypersplenism) in patients with nonalcoholic chronic liver disease. Am J Gastroenterol. 2000;95(10):2936-9.

Lu YF, Li XQ, Han XY, Gong XG, Chang SW. Peripheral blood cell variations in cirrhotic portal hypertension patients with hypersplenism. Asian Pac J Trop Med. 2013;6(8):663-6.

Kim MY, Baik SK, Lee SS. Hemodynamic alterations in cirrhosis and portal hypertension. Kor J Hepatol. 2010;16(4):347-52.

Centers for Disease Control and Prevention (CDC). Chronic liver disease and cirrhosis. 2018. Available at: www.cdc.gov/nchs/fastats/liver-disease.htm. Accessed on 25 January, 2023.

Qamar AA, Grace ND, Groszmann RJ. Platelet count and changes over time as predictors of gastroesophageal varices in cirrhosis. Hepatology. 2008;47:153-9.

Qamar AA, Grace ND, Groszmann RJ, Garcia-Tsao G, Bosch J, Burroughs AK et al. Portal Hypertension Collaborative Group. Incidence, prevalence, and clinical significance of abnormal hematologic indices in compensated cirrhosis. Clin Gastroenterol Hepatol. 2009;7(6):689-95.

Peck-Radosavljevic M. Thrombocytopenia in chronic liver disease. Liver Int. 2017;37(6):778-93.

Garcia-Tsao G, Sanyal AJ, Grace ND. Practice Guidelines Committee of the American Association for the Study of Liver Diseases; Practice Parameters Committee of the American College of Gastroenterology. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46:922-38.

Miller JB, Figueroa EJ, Haug RM, Shah NL. Thrombocytopenia in Chronic Liver Disease and the Role of Thrombopoietin Agonists. Gastroenterol Hepatol. 2019;15(6):326-32.

Andersen CJ, Murphy KE, Fernandez ML. Impact of Obesity and Metabolic Syndrome on Immunity. Adv Nutr. 2016;7(1):66-75.

Casulleras M, Zhang IW, López-Vicario C, Clària J. Leukocytes, Systemic Inflammation and Immunopathology in Acute-on-Chronic Liver Failure. Cells. 2020;9(12):2632.

Albillos A, Lario M, Álvarez-Mon M. Cirrhosis-associated immune dysfunction: distinctive features and clinical relevance. J Hepatol. 2014;61(6):1385-96.

Choong CC, Venkatesh SK, Siew EP. Accuracy of routine clinical ultrasound for staging of liver fibrosis. J Clin Imaging Sci. 2012;2:58.