Correlation between Severity of Thrombocytopenia and Portal Hypertensive Gastropathy in Patients with Chronic Liver Disease

Abstract

Introduction: Portal hypertensive gastropathy (PHG) is known but under detected complication of cirrhosis of liver. Patients with stable liver disease are more prone to internal bleeding due to portal hypertension. Thrombocytopenia is a common complication associated with chronic liver disease and it is associated with poor prognosis. The aim of this study is to find out the association between correlation between severity of thrombocytopenia and portal hypertensive gastropathy in patients with chronic liver disease.

Materials: This cross-sectional analytical study was conducted in a tertiary care centre at Saveetha Medical College Hospital and Research Centre. A total of 80 consecutive subjects were included in this study. All adult patients admitted with diagnosis chronic liver disease underwent upper GI endoscopy; those with portal hypertensive gastropathy were included in this study. The patient with liver disease with only varices but not gastropathy was excluded. Patient less than 18 years and with poor preparation were excluded from this study. Platelet count was estimated and severity of gastropathy was classified. Correlation of thrombocytopenia and severity of gastropathy was studied.

Result: Patients with mild portal hypertensive gastropathy category had normal platelet count between 1.5-4.5 lakhs/mm3 . But in patients with severe PHG, almost 80% of patients had thrombocytopenia, in which 8% had severe thrombocytopenia <50,000 cells/mm3 . The inverse relationship between the platelet count and the severity of PHG was statistically significant.

Conclusion: The severity of thrombocytopenia increased with increasing grade of portal hypertensive gastropathy. Hence platelet count can serve as the prognostic marker of chronic liver disease induced portal hypertensive gastropathy References Chung WJ. Management of portal hypertensive gastropathy and other bleeding. Clin Mol Hepatol 2014;20(1):1-5. Madhwani R, Hanif FM, Ul Haque MM, et al. Noninvasive clinical predictors of portal hypertensive gastropathy in patients with liver cirrhosis. J Transpl Int Med 2017;5(3):169-173.