The Significance of Serum Thrombopoietin Levels in Cirrhotic Patients with Thrombocytopenia According to Disease Severity.
- Author:
Jong Eun YEON
;
Whee KONG
;
Ji Hoon KIM
;
Yeon Suk SUH
;
Sang Hoon PARK
;
Oh Sang KWON
;
Kwan Soo BYUN
;
Chang Hong LEE
- Publication Type:Original Article
- Keywords:
Thrombopoietin;
Thrombocytopenia;
Liver disease
- MeSH:
Bile;
Bilirubin;
Blood Platelets;
Bone Marrow;
Child;
Drug Therapy;
Enzyme-Linked Immunosorbent Assay;
Hepatitis;
Hepatitis, Chronic;
Humans;
Hypersplenism;
Hypertension, Portal;
Liver;
Liver Cirrhosis;
Liver Diseases;
Megakaryocytes;
Partial Thromboplastin Time;
Platelet Count;
Prothrombin Time;
Serum Albumin;
Thrombocytopenia*;
Thrombopoietin*
- From:The Korean Journal of Hepatology
1999;5(3):208-216
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Thrombopoietin (TPO) is an important cytokine for megakaryocyte maturation and platelet production. Because the main site of its production is liver, the failing liver may have a role in thrombocytopenia in chronic liver disease. The aims of this study were to determine the serum TPO levels in cirrhotic patients with thrombocytopenia and clarify the relation between the serum TPO levels and liver function impairment. METHOD: Cirrhotic paitents with thrombocytopenia (LC, n=57, Child class A/B/C; 20/13/24), chronic hepatitis patients (CH, n=24), oncologic patients with thrombocytopenia induced by chemotherapy (HO, n=7), acute viral hepatitis patients (AVH, n=5) and healthy controls (HC, n=5) were enrolled. Serum TPO was measured by an ELISA method. RESULTS: Although the mean platelets counts of LC (69+/-32, x103/ul: mean+/-SD) were lower than those of HC (229+/-29, x103/ul), serum TPO levels in LC (108+/-63 pg/ml: mean+/-SD) were not significantly different from HC (122+/-24 pg/ml). In HO, serum TPO was significantly higher than LC (623+/-746 vs 108+/-63 pg/ml, p<0.05) inspite of comparable platelets counts. In LC, serum TPO level was not significantly different among Child class groups. It was not correlated with serum ALT, serum albumin levels, prothrombin time, serum bile acid, Child class, Child score and partial thromboplastin time, but weakly correlated with serum total bilirubin (p=0.038, r=0.288) and platelet counts (p=0.041, r=0.287). CONCLUSIONS: Although impaired hepatic production of TPO seems to be the main cause of low serum TPO levels in thrombocytopenic cirrhotic patients, there was no correlation between serum TPO level and the severity of liver dysfunction. The role of other factors such as megakaryocyte mass in bone marrow, portal hypertension and hypersplenism may be necessary to explain the putative mechanism between TPO and platelet numbers in liver cirrhosis with thrombocytopenia.
