Prevalence of peripheral blood cytopenias (Hypersplenism) in patients withnonalcoholic chronic liver disease

OBJECTIVE: Thrombocytopenia or leukopenia in patients with chronic liver di sease is often attributed to functional overactivity of the spleen (hypersp lenism). Despite being a fairly common phenomenon, there is a paucity of re ports on the prevalence of this syndrome in stable chronic Liver disease pa tients with or without severe fibrosis/cirrhosis. The aim of this study was to establish the prevalence of peripheral blood cytopenia in patients with nonalcoholic cirrhosis/severe fibrosis versus patients with mild or no fib rosis on liver biopsy. METHODS: This is a retrospective chart review of 235 patients who underwent a liver biopsy. One hundred ninety-one patients met strict criteria for st udy entry; 28 different clinical and laboratory variables were collected fr om their charts review, and data were then analyzed using the SPSS statisti cal package. RESULTS: Of the cirrhotic patients, 64% were noted to have platelet counts consistently below 150,000 (lower limit of normal in our laboratory; mean, 144.6 +/- 89.4; median, 114), whereas only 5.5% of noncirrhotic patients ha d thrombocytopenia (mean, 252.2 +/- 103.4; median, 238). Leukopenia (WBC, < 3,500) was relatively rare in the cirrhotic/ fibrotic group, having a preva lence of 5% (7.59 +/- 4.3) versus 3.3% (10.62 +/- 14.2) of noncirrhotic pat ients. CONCLUSIONS: Of the patients with cirrhosis, 64% had thrombocytopenia (plat elet count, <150,000). The Likelihood ratio of finding a platelet count of <100,000 in patients with cirrhosis, as opposed to patients without cirrhos is, is almost 12. (Am J Gastroenterol 2000;95:2936-2939. (C) 2000 by Am. Co ll. of Gastroenterology).