CHRONIC LIVER DISEASE WITH HYPERSPLENISM PRESENTING AS PANCYTOPENIA
(Abstract release date: 05/21/15)
EHA Library. Ryu H. 06/12/15; 102656; PB1707
Hyewon Ryu
Contributions
Contributions
Abstract
Abstract: PB1707
Type: Publication Only
Background
Aims
In this study, we reviewed and analysed the diagnostic process of chronic liver disease associated with hypersplenism initially presenting as pancytopenia.
Methods
Patients with chronic liver disease with hypersplenism who initially presented with bicytopenia or pancytopenia from January 2002 to December 2013 at Chungnam National University Hospital were enrolled. The patients’ characteristics and laboratory investigation findings at the time of diagnosis were analysed retrospectively.
Results
Nineteen patients with a median age of 61.5 years (range, 43–77 years) were enrolled, accounting for about 3% of patients presenting with bicytopenia or pancytopenia during the study period. All patients were first seen by a haematologist. In 12 patients (63.2%), bicytopenia or pancytopenia was incidentally found during a health check-up at a local clinic. A history of liver disease was limited to six patients (31.6%), and one patient (5.3%) was a carrier of the hepatitis B virus. Hepatitis B surface antigen and anti-hepatitis C antibody were detected in four (21.1%) and seven (36.9%) patients, respectively. Eighteen (94.7%) patients exhibited one or more abnormalities among the aspartate transaminase level, alanine transaminase level, alkaline phosphatase level, total bilirubin level, albumin level, and prothrombin time. All patients exhibited hepatic dysfunction and splenomegaly on Tc-99m phytate liver scintigraphy; therefore, all were diagnosed with liver cirrhosis accompanied by hypersplenism. The causes of the cirrhosis were hepatitis B in four patients (20.0%), hepatitis C in seven (36.9%), alcohol consumption in two (10.5%), chronic heart failure in one (5.3%), and an autoimmune disorder in one (5.3%). No clear aetiology was found in four (20.0%) patients. Of 15 patients with liver cirrhosis who underwent a bone marrow study, 2 (13.3%) were confirmed to have aplastic anaemia in addition to hypersplenism. Myelodysplastic syndrome and megakaryocytic hyperplasia were reported in three (20.0%) and two (13.3%) patients, respectively, and were later confirmed to be reactive changes of hypersplenism.
Summary
Chronic liver disease accompanied by splenomegaly and hypersplenism should be highly suspected when bicytopenia/pancytopenia and abnormalities in chemistry coexist in the same patient, even in those with no history of liver disease or who are negative for viral hepatitis markers. The Tc-99m liver scan is a simple but highly efficient investigational tool for these patients.
Keyword(s): Liver disease, Pancytopenia, Spleen
Type: Publication Only
Background
Hypersplenism is one cause of pancytopenia. Chronic viral hepatitis and liver cirrhosis are prevalent in Asian populations and often result in splenomegaly and hypersplenism.
Aims
In this study, we reviewed and analysed the diagnostic process of chronic liver disease associated with hypersplenism initially presenting as pancytopenia.
Methods
Patients with chronic liver disease with hypersplenism who initially presented with bicytopenia or pancytopenia from January 2002 to December 2013 at Chungnam National University Hospital were enrolled. The patients’ characteristics and laboratory investigation findings at the time of diagnosis were analysed retrospectively.
Results
Nineteen patients with a median age of 61.5 years (range, 43–77 years) were enrolled, accounting for about 3% of patients presenting with bicytopenia or pancytopenia during the study period. All patients were first seen by a haematologist. In 12 patients (63.2%), bicytopenia or pancytopenia was incidentally found during a health check-up at a local clinic. A history of liver disease was limited to six patients (31.6%), and one patient (5.3%) was a carrier of the hepatitis B virus. Hepatitis B surface antigen and anti-hepatitis C antibody were detected in four (21.1%) and seven (36.9%) patients, respectively. Eighteen (94.7%) patients exhibited one or more abnormalities among the aspartate transaminase level, alanine transaminase level, alkaline phosphatase level, total bilirubin level, albumin level, and prothrombin time. All patients exhibited hepatic dysfunction and splenomegaly on Tc-99m phytate liver scintigraphy; therefore, all were diagnosed with liver cirrhosis accompanied by hypersplenism. The causes of the cirrhosis were hepatitis B in four patients (20.0%), hepatitis C in seven (36.9%), alcohol consumption in two (10.5%), chronic heart failure in one (5.3%), and an autoimmune disorder in one (5.3%). No clear aetiology was found in four (20.0%) patients. Of 15 patients with liver cirrhosis who underwent a bone marrow study, 2 (13.3%) were confirmed to have aplastic anaemia in addition to hypersplenism. Myelodysplastic syndrome and megakaryocytic hyperplasia were reported in three (20.0%) and two (13.3%) patients, respectively, and were later confirmed to be reactive changes of hypersplenism.
Summary
Chronic liver disease accompanied by splenomegaly and hypersplenism should be highly suspected when bicytopenia/pancytopenia and abnormalities in chemistry coexist in the same patient, even in those with no history of liver disease or who are negative for viral hepatitis markers. The Tc-99m liver scan is a simple but highly efficient investigational tool for these patients.
Keyword(s): Liver disease, Pancytopenia, Spleen
Abstract: PB1707
Type: Publication Only
Background
Aims
In this study, we reviewed and analysed the diagnostic process of chronic liver disease associated with hypersplenism initially presenting as pancytopenia.
Methods
Patients with chronic liver disease with hypersplenism who initially presented with bicytopenia or pancytopenia from January 2002 to December 2013 at Chungnam National University Hospital were enrolled. The patients’ characteristics and laboratory investigation findings at the time of diagnosis were analysed retrospectively.
Results
Nineteen patients with a median age of 61.5 years (range, 43–77 years) were enrolled, accounting for about 3% of patients presenting with bicytopenia or pancytopenia during the study period. All patients were first seen by a haematologist. In 12 patients (63.2%), bicytopenia or pancytopenia was incidentally found during a health check-up at a local clinic. A history of liver disease was limited to six patients (31.6%), and one patient (5.3%) was a carrier of the hepatitis B virus. Hepatitis B surface antigen and anti-hepatitis C antibody were detected in four (21.1%) and seven (36.9%) patients, respectively. Eighteen (94.7%) patients exhibited one or more abnormalities among the aspartate transaminase level, alanine transaminase level, alkaline phosphatase level, total bilirubin level, albumin level, and prothrombin time. All patients exhibited hepatic dysfunction and splenomegaly on Tc-99m phytate liver scintigraphy; therefore, all were diagnosed with liver cirrhosis accompanied by hypersplenism. The causes of the cirrhosis were hepatitis B in four patients (20.0%), hepatitis C in seven (36.9%), alcohol consumption in two (10.5%), chronic heart failure in one (5.3%), and an autoimmune disorder in one (5.3%). No clear aetiology was found in four (20.0%) patients. Of 15 patients with liver cirrhosis who underwent a bone marrow study, 2 (13.3%) were confirmed to have aplastic anaemia in addition to hypersplenism. Myelodysplastic syndrome and megakaryocytic hyperplasia were reported in three (20.0%) and two (13.3%) patients, respectively, and were later confirmed to be reactive changes of hypersplenism.
Summary
Chronic liver disease accompanied by splenomegaly and hypersplenism should be highly suspected when bicytopenia/pancytopenia and abnormalities in chemistry coexist in the same patient, even in those with no history of liver disease or who are negative for viral hepatitis markers. The Tc-99m liver scan is a simple but highly efficient investigational tool for these patients.
Keyword(s): Liver disease, Pancytopenia, Spleen
Type: Publication Only
Background
Hypersplenism is one cause of pancytopenia. Chronic viral hepatitis and liver cirrhosis are prevalent in Asian populations and often result in splenomegaly and hypersplenism.
Aims
In this study, we reviewed and analysed the diagnostic process of chronic liver disease associated with hypersplenism initially presenting as pancytopenia.
Methods
Patients with chronic liver disease with hypersplenism who initially presented with bicytopenia or pancytopenia from January 2002 to December 2013 at Chungnam National University Hospital were enrolled. The patients’ characteristics and laboratory investigation findings at the time of diagnosis were analysed retrospectively.
Results
Nineteen patients with a median age of 61.5 years (range, 43–77 years) were enrolled, accounting for about 3% of patients presenting with bicytopenia or pancytopenia during the study period. All patients were first seen by a haematologist. In 12 patients (63.2%), bicytopenia or pancytopenia was incidentally found during a health check-up at a local clinic. A history of liver disease was limited to six patients (31.6%), and one patient (5.3%) was a carrier of the hepatitis B virus. Hepatitis B surface antigen and anti-hepatitis C antibody were detected in four (21.1%) and seven (36.9%) patients, respectively. Eighteen (94.7%) patients exhibited one or more abnormalities among the aspartate transaminase level, alanine transaminase level, alkaline phosphatase level, total bilirubin level, albumin level, and prothrombin time. All patients exhibited hepatic dysfunction and splenomegaly on Tc-99m phytate liver scintigraphy; therefore, all were diagnosed with liver cirrhosis accompanied by hypersplenism. The causes of the cirrhosis were hepatitis B in four patients (20.0%), hepatitis C in seven (36.9%), alcohol consumption in two (10.5%), chronic heart failure in one (5.3%), and an autoimmune disorder in one (5.3%). No clear aetiology was found in four (20.0%) patients. Of 15 patients with liver cirrhosis who underwent a bone marrow study, 2 (13.3%) were confirmed to have aplastic anaemia in addition to hypersplenism. Myelodysplastic syndrome and megakaryocytic hyperplasia were reported in three (20.0%) and two (13.3%) patients, respectively, and were later confirmed to be reactive changes of hypersplenism.
Summary
Chronic liver disease accompanied by splenomegaly and hypersplenism should be highly suspected when bicytopenia/pancytopenia and abnormalities in chemistry coexist in the same patient, even in those with no history of liver disease or who are negative for viral hepatitis markers. The Tc-99m liver scan is a simple but highly efficient investigational tool for these patients.
Keyword(s): Liver disease, Pancytopenia, Spleen
{{ help_message }}
{{filter}}