Erythrocyte creatine as a marker of excessive erythrocyte destruction due to hypersplenism in patients with liver cirrhosis

Objective: Erythrocyte creatine is a sensitive marker of erythrocyte age, a nd can be used to detect slight and continuous hemolysis. Excessive blood c ell destruction caused by increased spleen function is important evidence o f hypersplenism. This study evaluates the usefulness of erythrocyte creatin e as a sensitive marker of excessive erythrocyte destruction due to hypersp lenism in patients with liver cirrhosis. Design and Method: Erythrocyte creatine was determined by an enzymatic meth od in 50 patients with postnecrotic liver cirrhosis and 50 healthy controls . The spleen size was measured by ultrasonography and expressed as a spleen index. Results: The patients with splenomegaly showed significantly higher erythro cyte creatine than those without splenomegaly (p < 0.005) and healthy contr ols (p < 0.001), but there was no significant difference in erythrocyte cre atine between healthy controls and those without splenomegaly. Fourteen (93 %) of the 15 patients with abnormally high erythrocyte creatine (> 1.8 mu m ol/g hemoglobin) had splenomegaly. There were no significant differences in reticulocyte count between healthy controls and the patients with and with out splenomegaly. Erythrocyte creatine showed good correlations with spleen index (r = 0.67; p < 0.001) and reticulocytes (r = 0.63; p < 0.001). Conclusions: Erythrocyte creatine can be used for predicting erythropoietic status and estimating hypersplenism in patients with liver cirrhosis. (C) 2001 The Canadian Society of Clinical Chemists. All rights reserved.