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Are Hematological Parameters Associated with Disease Severity in Cirrhotic Patients?

C.M. Kiran, Associate Professor, Dept. of Pathology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry 605014, India. , E. Krithiga* , Chokka M. Kiran** , Anita Ramdas*** , Thomas Alexander****

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Indian Journal of Pathology: Research and Practice 7(1):p 45-51, January 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7118.8

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Abstract

Background: Hematological abnormalities are quite frequent in cirrhotic patients and commonly include various types of anemias, thrombocytopenia and increased PT/INR. Some of these parameters are used as prognostic markers in scoring systems like Child-Pugh and Model for End Stage Liver Disease (MELD). Aim: We aimed to assess the various hematological parameters in cirrhotic patients and correlate them with disease severity based on Child-Pugh and MELD scoring systems. Materials and Methods: 87 patients diagnosed with cirrhosis irrespective of etiology were studied over a period of 2 years. Complete blood count, peripheral smear and coagulation parameters were noted along with relevant clinical history. Variations in these were compared with Child-Pugh and MELD scoring systems. Results: Macrocytic anemia and spur cell anemia were seen in 33 and 7 patients respectively. Thrombocytopenia was noted in 33 patients. 67 patients had prolonged PT. According to Child-Pugh classification, 65.5% of patients came under Grade C, 27.6% under Grade B and 6% under Grade A respectively. According to MELD score, 24% of patients had a score < 15 and 76% had a score of 15. Hematological parameters like MCH, MCHC and Total count showed a significant positive correlation with both Child-Pugh and MELD scoring systems with p < 0.05. Hemoglobin, RBC count and RDW showed a negative correlation with both Child-Pugh and MELD scoring systems with p value < 0.05. Coagulation parameters PT and PT/INR showed a significant positive correlation with both Child-Pugh and MELD scoring with p value < 0.001. Conclusions: Although a number of hematological abnormalities are seen in cirrhotic patients, only few of them show significant correlation with disease severity. Hence it is suggested that these parameters be used for prognostication in cirrhotics.

Keywords: Child-Pugh; Cirrhosis; Hematological; MELD. 

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7118.8

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