Coagulation profile in liver diseases: A study of 250 cases in a tertiary care hospital

Abstract

Introduction:The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as it synthesizes most of the factors of coagulation cascade and fibrinolytic proteins. So it is responsible for regulation of haemostasis. Hepatic disorders are widely present in tropical countries and are responsible for morbidity and mortality. Aims and Objectives: The objective of this study was to evaluate coagulation abnormalities associated with chronic liver diseases using tests like prothrombin time (PT), and activated partial thromboplastin time (APTT). Materials and Methods:The study was conducted in the laboratory of Pathology department, during the period from October 2019 to June 2020. This study included 225 patients clinically diagnosed with liver disease who were divided into three categories: 1-cirrhosis, 2-other liver disease and 3-Hepatitis.The coagulation tests PT and APTT were performed and the results were evaluated in groups. 25 normal patients were taken as controls. Result: Out of 250 patients, 190(85%) were males and 60(24%) were females. A total of 13(6%) patients were of cirrhosis, 100 (44%) were of viral hepatitis and jaundice, and 112 (50%) were of other liver diseases and 25 normal patients (10%). Prothrombin time showed marked significant prolongation in all liver diseases. In cirrhosis: 90-100% bleeders showed elevation of Prothrombin time and non bleeders showed elevation in 50-55% cases. In viral hepatitis: 45% cases showed rise in PT. In Alcoholic liver diseases; 38.5% cases showed rise in PT. APTT is quite Significant in cirrhosis. In cirrhosis, Bleeders showed elevation of APTT in100% cases and non bleeders show 50% cases. In viral hepatitis, 25.3% rise in APTT in Alcoholic liver diseases, 25.9%cases showed rise in APTT. Conclusion:In advancing liver diseases, damage to liver parenchyma resulting in reduced production of coagulation proteins so there is increase in PT and APTT which increase the risk of bleeding tendencies. Prolongation of PT and APTT in advancing liver cirrhosis indicates damage to the liver parenchyma resulting in decreased production of coagulation proteins with increased risk of bleeding tendencies, which can be detected before these ensue.

Biomarkers of Hepatic Toxicity: An Overview

“…In viral hepatitis and obstructive jaundice, 2.5% have mild hypofibrinogenemia, suggesting fibrinogen has little value. 133 Prajapati et al 134 found that coagulation profile can measure hepatic cell activity and detect cellular harm. In advanced liver cirrhosis, liver parenchyma damage lowers coagulation protein production and increases bleeding risk.…”