Platelets in Chronic Liver Disease: Beyond Numbers

Objectives: Thrombocytopenia, a complication of Chronic Liver Disease (CLD), is considered to be a marker of advanced disease and an independent predictor of mortality. But this is disputable and hence is this study 1. To find out prevalence of thrombocytopenia in CLD; 2. To find out association with severity of liver disease and thrombocytopenia.

Materials And Methods: This was a descriptive study analyzing CLD patients diagnosed by clinical, biochemical, serological and radiological evaluation in our institution between March 2019 and December 2020.

Results: There were 48 patients; M: F 43:5; mean age 51.7±12.4 years; Thrombocytopenia: Mild (149999 – 75000/mm3) in 45.8%, moderate (74999 – 50000/mm3) in 12.5% and severe (< 49999/mm3) in 8.3%. There was no association of thrombocytopenia with severity indices like Child-Pugh Class (C. P. C.) and Model for End-stage Liver Disease – Sodium (MELD-Na) Score.

Conclusion: The prevalence of thrombocytopenia in CLD is 66.6% in this study. Thrombocytopenia is not associated with severity of disease. This necessitates larger studies and analyzing the factors other than number of platelets. This includes 1. functional status of platelets (thrombocythemia) 2. In a stable CLD, haemostasis and coagulation pathways achieve a delicate “rebalance state” (new normal) which may be disturbed even by trivial insult. 3. Platelets also secrete platelet derived growth factor, transforming growth factor β, hepatocyte growth factor which can influence liver fibrosis and regeneration.