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BMC Gastroenterology
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Open Access 01-12-2023 | Acute Pancreatitis | Research

Clinical significance of reactive thrombocytosis in the course of acute pancreatitis

Authors: Nobutaka Chiba, Atsunori Sugita, Minori Mizuochi, Jun Sato, Takeshi Saito, Atsushi Sakurai, Kosaku Kinoshita

Published in: BMC Gastroenterology | Issue 1/2023

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Abstract

Background

Reactive thrombocytosis occurs secondary to systemic infections, inflammatory, and other conditions. The relationship between thrombocytosis and acute pancreatitis (AP) in inflammatory diseases is uncertain. This study aimed to evaluate the clinical significance of thrombocytosis in AP patients during hospitalization.

Methods

Subjects within 48 h of AP onset were consecutively enrolled over 6 years. Platelet counts of ≥ 450,000/µL were defined as thrombocytosis, < 100,000/µL as thrombocytopenia, and other counts as normal. We compared clinical characteristics, including the rate of severe AP (SAP) assessed by the Japanese Severity Score; blood markers, including hematologic and inflammatory factors and pancreatic enzymes during hospitalization; and pancreatic complications and outcomes in the three groups.

Results

A total of 108 patients were enrolled. Although, SAP was more common in patients with thrombocytosis and thrombocytopenia (87.9% and 100%, respectively), the differences in lymphocytes and C-reactive protein, lactase dehydrogenase, and antithrombin levels, which are factors of the systemic inflammatory response, and the mean platelet volume, an indicator of platelet activation, were observed among patients with thrombocytosis and thrombocytopenia during hospitalization. Regarding pancreatic complications and outcomes, patients with thrombocytosis and thrombocytopenia had higher acute necrotic collection (ANC), pancreatic necrosis, intestinal paralysis, respiratory dysfunction, and pancreatic-related infection levels than patients with normal platelet levels. The relationship between pancreatic complications and thrombocytosis was assessed by multivariate logistic regression; the odds ratios for development of ANC, pancreatic necrosis and pancreatic-related infections were 7.360, 3.735 and 9.815, respectively.

Conclusions

Thrombocytosis during hospitalization for AP suggests development of local pancreatic complications and pancreatic-related infections.
Literature
1.
Wilson PG, Manji M, Neoptolemos JP. Acute pancreatitis as model of sepsis. J Antimicrob Chemother. 1998;41(suppl):51–63.PubMedCrossRef
2.
Iserman R, Rau B, Beger HG. Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis. Br J Surg. 1998;86:1020–4.CrossRef
3.
Tenner S, Sica G, Highes M, Noordhoek E, Feng S, Zinner M, et al. Relationship of necrosis to organ failure in severe acute pancreatitis. Gastroenterology. 1997;113:899–903.PubMedCrossRef
4.
McFadden DW. Organ failure and multiple organ system failure in pancreatitis. Pancreas. 1991;6(suppl):37–43.CrossRef
5.
Bradley EL, Allen K. A prospective longitudinal study of observation versus surgical intervention in the management of necrotizing pancreatitis. Am J Surg. 1991;161:19–25.PubMedCrossRef
6.
7.
Malleo G, Mazzon E, Siriwardena AK, Cuzzocrea S. Role of tumor necrosis factor-alpha in acute pancreatitis: from biological basis to clinical evidence. Shock. 2007;28:130–40.PubMedCrossRef
8.
Papachristou GI, Clermont G, Sharma A, Yadav D, Whitcomb DC. Risk and markers of severe acute pancreatitis. Gastroenterol Clin North Am. 2007;36:277–96.PubMedCrossRef
9.
Dambrauskas Z, Gulbinas A, Pundzius J, Barauskas G. Value of the different prognostic systems and biological markers for predicting severity and progression of acute pancreatitis. Scand J Gastroenterol. 2010;45:959–70.PubMedCrossRef
10.
Zrnić IK, Milić S, Fisić E, Radić M, Stimac D. C-reactive protein and lactate dehydrogenase as single prognostic factors of severity in acute pancreatitis. Lijec Vjesn. 2010;129:1–4.
11.
Maeda Keisuke. Applicability of disseminated intravascular coagulation parameters in the assessment of the severity of acute pancreatitis. Pancreas. 2006;32:87–92.PubMedCrossRef
12.
Takeyama Y, Takase K, Ueda T, Hori Y, Goshima M, Kuroda Y. Peripheral lymphocyte reduction in severe acute pancreatitis is caused by apoptotic cell death. J Gastrointest Surg. 2000;4:379–87.PubMedCrossRef
13.
McNicol A, Israels SJ. Beyond hemostasis: the role of platelets in inflammation, malignancy and infection. Cardiovasc Hematol Disord Drug Targets. 2008;8:99–117.PubMedCrossRef
14.
Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG, Koutroumbakis IE, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol. 2001;96:776–81.PubMedCrossRef
15.
Balci SB, Aktas G. A Comprehensive Review of the role of hemogram-derived inflammatory markers in gastrointestinal conditions. Iran J Colorectal Res. 2022;10:75–86.
16.
Cakır L, Aktas G, Mercimek OB, Enginyurt O, Kaya Y, Mercimek K. Are red cell distribution width and mean platelet volume associated with rheumatoid arthritis. Biomed Res. 2016;27:292–4.
17.
Aktas G, Kocak MZ, Duman TT, Erkus E, Atak BM, Sit M, et al. Mean platelet volume (MPV) as an inflammatory marker in type 2 diabetes mellitus and obesity. Bali Med J. 2018;7:650–3.CrossRef
18.
Cakir L, Aktas G, Enginyurt O, Cakir SA. Mean platelet volume increases in type 2 diabetes mellitus independent of HbA1c level. Acta Med Mediterranea. 2014;30:425–8.
19.
A-Tel BM, Bilgin S, Kurtkulagi O, Kahveci G, Duman TT, Sagdic T, et al. Frailty in Diabetic subjects during COVID-19 and its Association with HbA1c, Mean platelet volume and Monocyte/ /Lymphocyte ratio. Clin Diabetol. 2022;11:119–26.CrossRef
20.
Aktas G, Cakiroglu B, Sit M, Uyeturk U, Alcelik A, Savli H, et al. Mean platelet volume: a simple indicator of chronic prostatitis. Acta Med Mediterranea. 2013;29:551–4.
21.
Bilgin S, A-Tel BM, Kahveci G, Duman TT, Kurkulagi O, Yurum S, et al. Hypothyroidism is strongly correlated with Mean platelet volume and red cell distribution width. Natl J Health Sci. 2021;6:7–10.CrossRef
22.
Sincer I, Çekici Y, Cosgun M, Aktas G, Gunes Y, Erdal E, et al. Does Mean platelet volume decrease in the presence of coronary artery Fistula? Arq Bras Cardiol. 2019;113:71–6.PubMedPubMedCentral
23.
Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D, Spanoudakis E, Bourikas G, et al. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology. 2004;4:22–7.PubMedCrossRef
24.
Erbis H, Aliosmanoglu I, Turkoglu MA, Ay E, Turkoglu A, Ulger BV. Evaluating mean platelet volume as a new indicator for confirming the diagnosis of necrotizing pancreatitis. Ann Ital Chir. 2014;86:132–6.
25.
Osada J, Werezczynska-Siemiatkowska U, Dabrowski A, Dabrowska MI. Platelet activation in acute pancreatitis. Pancreas. 2012;41:1319–24.PubMedCrossRef
26.
Ranson JH, Lackner H, Berman IR, Schinella R. The relationship of coagulation factors to clinical complications of acute pancreatitis. Surgery. 1977;81:502–11.PubMed
27.
28.
Mofidi R, Duff MD, Wigmore SJ, Madhavan KK, Garden OJ, Parks RW. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis. Br J Surg. 2006;93:738–44.PubMedCrossRef
29.
Jiang L, Ding W, Zhang M. The progressive increase of the platelet count in a patient with acute severe pancreatitis. Am J Emerg Med. 2017;35:191e1–2.CrossRef
30.
Takeda K, Yokoe M, Takada T, Kataoka K, Yoshida M, Gabeta T, et al. Assessment of severity of acute pancreatitis according to new prognostic factors and CT grading. J Hepatobiliary Pancreat Sci. 2010;17:37–44.PubMedCrossRef
31.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818–29.PubMedCrossRef
32.
Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, et al. The SOFA (Sepsis-related Organ failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–10.PubMedCrossRef
33.
Mortele KJ, Wiesner W, Intriere L, Shankar S, Zou KH, Kalantari BN, et al. A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. Am J Roentgenol. 2004;183:1261–5.CrossRef
34.
Wu BU, Jahannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57:1698–703.PubMedCrossRef
35.
Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis­2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–11.PubMedCrossRef
36.
37.
Fujimura Y, Hirota M, Ichihara A, Takamori H, Baba H. Platelet count as a sensitive and convenient parameter for assessing the prognosis in acute pancreatitis. Pancreas. 2008;37:225–8.PubMedCrossRef
38.
Deng H, Yu X, Gao K, Liu Y, Tong Z, Liu Y, et al. Dynamic nomogram for predicting thrombocytopenia in adults with acute pancreatitis. J Inflamm Ress. 2021;14:6657–67.CrossRef
39.
Marshall JC, Cook DJ, Christon NV, Bernard GR, Sprung CL, Sibbald WJ. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1632–52.CrossRef
40.
Umapathy C, Gajendran M, Mann R, Boregowda U, Theethira T, Elhanafi S, et al. Pancreatic fluid collections: clinical manifestations, diagnostic evaluation and management. Dis Mon. 2020;66:100986.PubMedCrossRef
41.
Beger HG, Bittner R, Block S, Büchler M. Bacterial contamination of pancreatic necrosis: a prospective study. Gastroenterology. 1986;91:433–8.PubMedCrossRef
42.
Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS, et al. Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. Ann Surg. 2012;256:875–80.PubMedCrossRef
43.
Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996;7:157–61.PubMedCrossRef
44.
Papadopoulos VP, Filippou DK, Mimidis KP. Mean platelet volume in acute pancreatitis: a systematic review and meta-analysis. Annals of Gastroenterology. 2020;33:398–404.PubMedPubMedCentral
45.
Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issue. Platelets. 2002;13:301–6.PubMedCrossRef
46.
Lei JJ, Zhou L, Liu Q, Xiong C, Xu CF. Can mean platelet volume play a role in evaluating the severity of acute pancreatitis? World J Gastroenterol. 2017;23:2404–13.PubMedPubMedCentralCrossRef
47.
Bautista AP, Buckler PW, Towler HM, Dawson AA, Bennett B. Measurement of platelet life span in normal subjects and patients with myeloproliferative disease with indium oxine labelled-platelets. Br J Haematol. 1984;58:679–87.PubMedCrossRef
48.
Blasi RADe, Cardelli P, Costante A, Sandri M, Mercieri M, Arcioni R. Immature platelet fraction in predicting sepsis in critically ill patients. Intensive Care Med. 2013;39:636–43.CrossRef
Metadata
Title
Clinical significance of reactive thrombocytosis in the course of acute pancreatitis
Authors
Nobutaka Chiba
Atsunori Sugita
Minori Mizuochi
Jun Sato
Takeshi Saito
Atsushi Sakurai
Kosaku Kinoshita
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02837-w

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