Haematological Abnormalities in Cirrhosis of Liver

Shanmugananthan, M (2007) Haematological Abnormalities in Cirrhosis of Liver. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Cirrhosis is one of the commonest diseases affecting man. Hepatic cirrhosis can occur at any age and often causes prolonged morbidity. It frequently manifests itself in younger adults and is an important cause of premature death. Liver disease produces a diverse range of haemotological effects. Liver disease can affect all the formed elements of blood RBCS, WBCS, and platelets. Liver disease has important effects on haemostasis. The liver plays a central role in the synthesis of many proteins and the maintenance of metabolic homeostasis. It is therefore not surprising that the development of clinically important liver diseases is accompanied by diverse manifestations. Although some functions are more sensitive than others, the liver has considerable reserve capacity, so, minimal or even moderate cell injury may not be reflected by measurable functional changes. Impaired liver functions are most evident in the patient with advanced liver disease, and the manifestations are similar regardless of initial insult. To a varying degree, similar abnormalities are observed in patients with severe chronic hepatitis, micronodular cirrhosis and post necrotic cirrhosis. AIM OF THE STUDY: 1. To detect various Haematological Abnormalities in Cirrhosis. 2. To Detect Reversible Factors like Anaemia, thrombocytopenia. So that correction of them may make the patients life less miserable. 3. To assess haemostatic functions of the liver in cirrhosis. MATERIALS AND METHODS: This study was conducted in Government Stanley hospital, Chennai – 3, Between Sept-2005 to Aug-2006. Fifty patients suffering from cirrhosis were selected in random for the study. 42 of them were males & 8 were females. Blood samples obtained from the patients were personally handed over to clinical pathological dept. The age group of the patients was from 20 to 65 years. The majority of the patients were daily wage coolies, coming from lower socioeconomic group. Their diet is particularly poor in protein. Past history of Jaundice was obtained in 16 patients. History f alcoholism was obtained in 36 patients. In the majority of patients Oesophageal varices seen in upper GI endoscopy were taken as indirect evidence while tissue proof obtained by performing the liver biopsy was considered to be direct evidence of cirrhosis. USG abdomen was routinely performed in all the patients. In these patients in whom liver biopsy was not performed due to contraindication or in whom the procedure was not successful, the coarse heterogenous echotexture of liver found in these patients was considered to be the direct evidence for the cirrhosis. Bone marrow study was carried out in forty patients. The following Haematological studies were carried out to assess red blood cell Abnormality: 1. RBC count, 2. Heamoglobin Estimation, 3. PCV, 4. MCV, 5. MCHC, 6. Peripheral Smear, 7. Reticulocyte count. To assess white blood cell abnormality: 1. Total WBC count, 2. DCTo assess Haemostasis: 1. Platelet count, 2. Bleeding time / Clotting time, 3. Prothrombin time. SUMMARY AND CONCLUSION: This limited study aimed at the evaluation of haematological profile in liver cirrhosis patients. As expected most of the patients have some form of disturbance in the haematological profile. Majority of the patients suffered from anaemia in one form or other. Next in the order is referable to platelet abnormalities. Thirdly small proportion of patients found to be suffering from leucocytes disturbances. Since anaemia is found to be the major haematological abnormality in our study we aimed at correcting this problem first by giving either packed cell volume or whole blood transfusion as the case may be. This definitely as reduce the immediate mortality. Hence, we suggest that all cirrhotic patients should be carefully monitored regarding the haematological profile and correcting these abnormalities would certainly prevent death due to anaemia, inter current infections, sepsis and hypovolemic shock due to haemorrhage.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Haematological Abnormalities ; Cirrhosis ; Liver.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 23 Mar 2018 04:34
Last Modified: 24 Mar 2018 07:18
URI: http://repository-tnmgrmu.ac.in/id/eprint/6456

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