Abstract
COMPARISON OF THROMBOPOIETIN LEVELS IN PATIENTS WITH CHRONIC LIVER DISEASE T.E Tu~lular, E. Av~ar, M. Ekenel, E Uras, N. T6ztin Marmara University Gastroenterology Institute, Istanbul, Turkey. Thrombocytopenia is a well known hematologic complication of liver cirrhosis. Splenic sequestration and antibody mediated destruction of platelets are blamed in the etiology of thromboeytopenia seen in chronic liver diseases. Thrombopoietin is the key regulatory cytokine in the production and proliferation of platelets. It is mainly produced in the liver, so thromboeytopenia associated with liver cirrhosis can be related to inadequate production of thrombopoietin by the liver. Aim: The aim of our study is to compare thrombopoietin levels in thrombocytopenias with different etiologies. Materials and methods: We measured peripheral platelet counts and thrombopoietin levels in 20 patients with chronic hepatitis (CH), 17 patients with cirrhosis and 20 patients with chemotherapy induced thrombocytopenia (CIT) with normal liver functions. Serum thrombopoietin levels were measured by ELISA. Results: Mean serum thrombopoietin levels in patients with chronic hepatitis, cirrhosis and chemotherapy induced thromboeytopenia were 89~48.8, 69.7~-45.8 and 1541.8±893.0 pg/ml. Respectively. Levels of serum thrombopoietin in CH and cirrhosis were significantly lower, when compared to patients with CIT (p<0.0001). There were no differences beetween the levels of thrombopoietin in patients with CH and cirrhosis. There was no correlation between platelet count and serum thrombopoietin levels in patients with CH and cirrhosis, but we found a slight correlation in CIT patients (p<0.0658). Conclusions: Although there may be other contributing factors, it seems that reduced production of the thrombopoietin by the liver is the major pathophysiologic factor in the etiology of thrombocytopenia seen in cirrhosis. Cirrhosis and its complications, pathophysiology and clinical aspects
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