Thrombocytopenia in Patients with Chronic Liver Disease: What’s in a Name?

Excerpt

Thrombocytopenia is likely the most common haematological alteration that can be observed in patients affected by chronic liver disease [1]. In compensated cirrhosis, it is the most prevalent and incident peripheral blood cytopenia; in chronic hepatitis C patients, thrombocytopenia represents an obstacle to antiviral therapy in 6.5 % of patients who are otherwise good candidates for interferon treatment [2, 3]. Furthermore, besides being the hallmark of a possible increased risk of bleeding, thrombocytopenia has several diagnostic and prognostic meanings [4, 5]. This versatile use of platelet count and thrombocytopenia is supported by the multi-faceted etiology of decreased platelet count in chronic liver disease patients [1, 5]. Indeed, the platelet count is incorporated into numerous diagnostic algorithms aimed at non-invasively assessing the severity of chronic liver diseases and features of portal hypertension, can be used to pinpoint patients at higher risk of developing hepatocellular carcinoma in population studies, and is a predictor of death in cirrhotic patients with and without hepatocellular carcinoma [6‐12]. …