Association of liver cirrhosis severity with anemia: does it matter?

Singh, Sonal; Manrai, Manish; Parvathi, V S; Kumar, Dharmendra; Srivastava, Sharad; Pathak, Basant Kumar

doi:10.20524/aog.2020.0478

Cited by 22 publications

(18 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anemia is the most common complication of liver cirrhosis, and the etiology of anemia in liver disease is diverse and often multifactorial. 8 The common causes are acute and chronic blood loss due to upper gastrointestinal bleeding, malnutrition, hypersplenism secondary to portal hypertension, and impaired coagulation. 8 Contrast with the literature, in this case the patient never had bleeding history, including hematochezia, melena, hematemesis, and hemoptoe.…”

Section: Discussionmentioning

confidence: 99%

Hepatic cirrhosis causes pancytopenia: a case report

Dana¹,

Mediana²,

Murti³

et al. 2021

Int J Adv Med

View full text Add to dashboard Cite

Hepatic cirrhosis is a slow process liver disease, persisting over a long period of time, resulting in a progressive destruction, and is the final common pathological pathway. We report a case of 60-year-old man with hepatic cirrhosis and pancytopenia. He came to emergency room with chronic fatigue, light headed, and abdominal pain. In laboratory examination, hemoglobin 6.0 g/dL, red blood cell counts 2.8×106/mm3, platelets 58.000×103/mm3, leukocytes 3.800×103/mm3, and reactive HbsAg. Abdominal ultrasound revealed small liver with irregular edges, ascitic fluid, and enlarged spleen. The patient was treated with furosemide, spironolactone, lactulose and propranolol. The liver, or the hepatocyte constitutes a significant storage site for iron, produce erythropoietin and thrombopoietin. Hypersplenism causes retention of a large number of leukocytes, erythrocytes, and platelets in the spleen, and the number of retained blood cells can be 5.5-20 times higher than the normal level, thus facilitating capture, phagocytosis or destruction of blood cells by phagocytes resulting in peripheral cytopenias. This case illustrated that hepatic cirrhosis can cause pancytopenia. Therefore, we must look for any cause of pancytopenia in a patient with chronic liver disease. Lack of thrombopoietin and erythropoietin production, lack of iron storage in damaged hepatocyte, also splenic sequestration were the reason of pancytopenia in hepatic cirrhosis. Bone marrow examination is one of modalities that can be use, and still being recommended examination.

show abstract

Section: Discussionmentioning

confidence: 99%

Hepatic cirrhosis causes pancytopenia: a case report

Dana¹,

Mediana²,

Murti³

et al. 2021

Int J Adv Med

View full text Add to dashboard Cite

show abstract

“…This suggests that lower haemoglobin levels are associated with an increased risk of post-BL ulcer bleeding. Singh et al [25] found that haemoglobin levels decrease spontaneously with the increasing severity of liver disease. This may suggest that our case group had more severe liver cirrhosis and therefore more severe varices than the control group.…”

Section: Discussionmentioning

confidence: 99%

Bleeding from band ligation-induced ulcers following the treatment of oesophageal varices: a retrospective case–control study.

Swai²

2020

Preprint

View full text Add to dashboard Cite

Background Band ligation (BL) plays a vital role in the treatment of oesophageal varices; however, the procedure carries a considerable risk of band slippage, variceal site ulcer formation and post-treatment bleeding. Our study aimed to explore the incidence of post-BL ulcer bleeding and to identify possible associated factors.Methods We retrospectively reviewed the records of patients with oesophageal varices who underwent endoscopic haemostasis by BL at our institution between 2015 and 2020. We statistically compared the patients with post-BL ulcer bleeding and those without (controls). The outcome variable was the development of BL-induced ulcer bleeding. The patients’ demographics, clinical and laboratory parameters, BL procedure outcomes and experts’ opinions were used as the independent variables and possible associated factors. Results Of the 4579 eligible patients 388 (8.5%) presented with post-BL ulcer bleeding. Proton pump inhibitor (PPI) use was associated with a lower risk of post-BL ulcer bleeding (odds ratio, 0.77; 95% confidence interval [CI]: 0.603–0.983). The presence of high-risk stigmata indicated a 1.276 times higher risk of bleeding (CI: 1.024–1.592), and a greater number of varices was associated with an increased risk of post-BL ulcer bleeding (P = 0.007). The use of fewer bands per variceal site was associated with fewer bleeding incidents (P = 0.008), while lower haemoglobin levels were associated with a higher probability of bleeding (P = 0.007).Conclusions The overall incidence of post-BL ulcer bleeding was 8.5%. The presence of high-risk stigmata and a higher number of varices and bands per variceal site were associated with an increased risk of bleeding. Adequate haemoglobin levels and the use of adjuvant PPIs and having were protective factors.

show abstract

“…The associated anemia entirely resolved in half of our patients and improved in 87.5% of patients six to twelve months after OLT. Anemia is common in cirrhotic patients; however, it is usually complex, and may be influenced by several factors, including etiology of cirrhosis and degree of portal hypertension[ 29 , 30 ] . Portal hypertension and hypersplenism can be contributing factors to anemia in cirrhosis; however, the magnitude of the effect is unclear[ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Outcome of gastric antral vascular ectasia and related anemia after orthotopic liver transplantation

Ali

Benrajab

Cruz

2020

WJH

View full text Add to dashboard Cite

BACKGROUND Gastric antral vascular ectasia (GAVE) is a significant complication of cirrhosis. Numerous medical, surgical, and endoscopic treatment modalities have been proposed with varied satisfactory results. In a few small studies, GAVE and associated anemia have resolved after orthotopic liver transplantation (OLT). AIM To assess the impact of OLT on the resolution of GAVE and related anemia. METHODS We retrospectively reviewed clinical records of adult patients with GAVE who underwent OLT between September 2012 and September 2019. Demographics and other relevant clinical findings were collected, including hemoglobin levels and upper endoscopy findings before and after OLT. The primary outcome was the resolution of GAVE and its related anemia after OLT. RESULTS Sixteen patients were identified. Mean pre-OLT Hgb was 7.7 g/dL and mean 12 mo post-OLT Hgb was 11.9 g/dL, ( P = 0.001). Anemia improved (defined as Hgb increased by 2g) in 87.5% of patients within 6 to 12 mo after OLT and resolved completely in half of the patients. Post-OLT esophagogastroduodenoscopy was performed in 10 patients, and GAVE was found to have resolved entirely in 6 of those patients (60%). CONCLUSION Although GAVE and associated anemia completely resolved in the majority of our patients after OLT, GAVE persisted in a few patients after transplant. Further studies in a large group of patients are necessary to understand the causality of disease and to better understand the factors associated with the persistence of GAVE post-transplant.

show abstract

Association of liver cirrhosis severity with anemia: does it matter?

Cited by 22 publications

References 17 publications

Hepatic cirrhosis causes pancytopenia: a case report

Hepatic cirrhosis causes pancytopenia: a case report

Bleeding from band ligation-induced ulcers following the treatment of oesophageal varices: a retrospective case–control study.

Outcome of gastric antral vascular ectasia and related anemia after orthotopic liver transplantation

Contact Info

Product

Resources

About