Thrombocytopenia associated with chronic liver disease

Nezam Afdhal, John McHutchison, Robert Brown, Ira Jacobson, Michael Manns, Fred Poordad, Babette Weksler, Rafael Esteban

Research output: Contribution to journalReview article

296 Scopus citations

Abstract

Thrombocytopenia (platelet count <150,000/μL) is a common complication in patients with chronic liver disease (CLD) that has been observed in up to 76% of patients. Moderate thrombocytopenia (platelet count, 50,000/μL-75,000/μL) occurs in approximately 13% of patients with cirrhosis. Multiple factors can contribute to the development of thrombocytopenia, including splenic platelet sequestration, bone marrow suppression by chronic hepatitis C infection, and antiviral treatment with interferon-based therapy. Reductions in the level or activity of the hematopoietic growth factor thrombopoietin (TPO) may also play a role. Thrombocytopenia can impact routine care of patients with CLD, potentially postponing or interfering with diagnostic and therapeutic procedures including liver biopsy, antiviral therapy, and medically indicated or elective surgery. Therapeutic options to safely and effectively raise platelet levels could have a significant effect on care of these patients. Several promising novel agents that stimulate TPO and increase platelet levels, such as the oral platelet growth factor eltrombopag, are currently in development for the prevention and/or treatment of thrombocytopenia. The ability to increase platelet levels could significantly reduce the need for platelet transfusions and facilitate the use of interferon-based antiviral therapy and other medically indicated treatments in patients with liver disease.

Original languageEnglish (US)
Pages (from-to)1000-1007
Number of pages8
JournalJournal of Hepatology
Volume48
Issue number6
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

Keywords

  • Chronic liver disease
  • Cirrhosis
  • Cytopenia
  • Platelet transfusion
  • Platelets
  • Thrombocytopenia
  • Thrombopoietin

ASJC Scopus subject areas

  • Hepatology

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