RED BLOOD CELL CHANGES IN ACUTE VIRAL HEPATITISES OF VARIOUS ETIOLOGY

Abstract

The aim of this work was the study of red blood indices in patients with acute viral hepatitises (AVH) and the effect of omeprazole treatment and comorbidities of pancreas and thyroid. Red blood indices were studied in the course of the disease in 167 AVH patients, including 35 cases with AVH "A", 43 cases with AVH "B", and 89 cases – with AVH "C". Patients were divided into follows: control group (112 patients) treated with standard therapy and studied group (55 patients), received the therapy with omeprazole due to preexisting pancreatitis. Studies were performed with the use of Sysmex Hematology Analyzer KX-21n. Red blood cells, hemoglobin, MCV, MCH, MCHC, RDWc were determined. In acute AVH certain changes in erythrocyte hemogram were found, namely anisocytosis in 39-74% of cases, increase of MCH in 15-23% of cases and MCHC lowering in 28-42% of cases. These changes are more specific for hepatitis "B" and "C", and are less common and less severe in hepatitis "A". Diserythropoiesis remains till the period of reconvalescence in 38-46% of cases in the form of macroanisocytosis and deceased hemoglobin formation (13-38% of cases), and in 19-33% of cases in the form of hyperchromic erythrocytes. Pathological changes in erythrocyte hemogram were exacerbated by concomitant thyroid disease in acute hepatitis "C" and the pathology of the pancreas in acute hepatitis "A". No association between omeprazole treatment and development of anisocytosis in AVH patients was found. Typical changes in the morphofunctional state of red blood cells in AVH are: the decrease in the average hemoglobin concentration (MCHC), and increase in the erythrocyte anisocytosis (RDWc). Anisocytosis, disturbance in hemoglobin formation and in some cases - hyperchromia of erythrocytes remain during the recovery period. Development of anisocytosis is mostly determined with the viral exposure than with comorbidity or omeprazole treatment and can be considered an independent sign of viral infection of the liver.