Balasubramanian, G (2007) A Study on the Platelet Dysfunction in Chronic Liver Disease. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
INTRODUCTION : Liver dysfunction is frequently accompanied by a hemostatic defect.Bleeding is usually due to an anatomic lesion that is exacerbated by a hemostatic defect. Most patients with chronic liver disease bleed from complications of portal hypertension,esophageal varices, or gastritis and peptic ulcer disease.Portal hypertension also causes splenomegaly, with splenic sequestration of platelets and thrombocytopenia, which contributes to the hemostatic defect. Other causes of bleeding are variceal rupture,coagulation disorders due to multiple causes : decreased synthesis of clotting and inhibitor factors ; decreased clearance of activated factors , quantitative and qualitative platelet defects , hyperfibrinolysis and accelerated intravascular coagulation. Bleeding from the gastrointestinal tract is also an important determining factor of mortality in such patients. In patients with chronic liver disease platelet dysfunction is an important contributing factor for bleeding which is not usually recognized in the routine clinical practice. Moreover tests assessing the functional status of platelets are seldom done in the laboratory due to various reasons. This study is conducted from a tertiary referral centre for gastroenterological problems offering services free of cost to poor sections of the society. Patients who presented to our hospital with various complaints pertaining to chronic liver disease as well as those who were referred as chronic liver disease were taken up for the study. Their blood samples were taken for analysis of platelet dysfunction and the tests were carried out in the Department of Biochemistry, Bharathi Women’s College (Autonomous), Chennai. AIM OF THE STUDY : To assess the qualitative platelet function in patients with chronic liver disease. 1. To analyse the severity of platelet dysfunction in chronic liver disease patients with UGI bleed. 2. To compare the individual qualitative platelet function test in chronic liver disease patients. 3. To assess the contribution of platelet dysfunction in UGI bleed occurring in lesser grade of esophageal varices with relatively good liver function. 4. To determine the significance of regular assessment of qualitative platelet function in patients with chronic liver disease. CONCLUSION : Qualitative function of platelets is defective in all patients with chronic liver disease 1. There is no correlation between platelet dysfunction and bleeding in patients with chronic liver disease. 2. Estimation of nitric oxide in plasma appears to be a more sensitive marker of platelet dysfunction among the various tests for platelet dysfunction. 3. Platelet dysfunction is a contributing factor in UGI bleed occurring in lesser grade of esophageal varices with relatively good liver function. 4. At present there is no definite role for assessment of qualitative platelet function in the routine management of patients with chronic liver disease.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Platelet Dysfunction ; Chronic Liver Disease. |
| Subjects: | MEDICAL > Gastroenterology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 14 Jul 2017 02:45 |
| Last Modified: | 14 Jul 2017 02:45 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1600 |
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