Platelet count to spleen diameter ratio non‐invasively identifies severe fibrosis and cirrhosis in patients with autoimmune hepatitis

Abstract

PC/SD ratio proved to be a simple non-invasive tool to correctly identify AIH patients with severe fibrosis and cirrhosis, thereby reducing the need for a liver biopsy in these patients.

Noninvasive inflammatory markers for assessing liver fibrosis stage in autoimmune hepatitis patients

“…Antibodies were detected by linear immunoassay using the IMTEC-LIVER LIAS (Human Gesellschaft fur Biochemica und Diagnostica GmbH, Wiesbaden, Germany). The lymphocyte-to-neutrophil ratio (LNR), lymphocyte-to-platelet ratio (LPR), lymphocyte-tomonocyte ratio (LMR) [18,19], AAR [13,14], immunoglobulin-to-platelet ratio (IGPR) [15,20,21], APRI [15,22,23], FIB-4 [15,22,24] and model for end-stage liver disease score (MELD) [13] were calculated as follows:…”

“…Indeed, several markers have been developed and validated for assessing liver fibrosis versus no-fibrosis; these include the fibrosis-4 score (FIB-4) and the aminotransferase-to-platelet ratio index (APRI) [9][10][11][12]. Other markers with promising results in clinical use are the aspartate aminotransferase (AST)-to-alanine aminotransferase (ALT) aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) [13], the platelet (PLT) count-to-spleen diameter ratio [14], and red blood cell distribution width [15]. However, to our knowledge, no studies have identified the ordinal or quantitative association of markers with fibrosis stage in AIH patients.…”

Evolving strategies for liver fibrosis staging: The non-invasive assessment

“…Recently, Sheptulina et al[19] evaluated the capacity of non-invasive markers [fibrosis-4 (FIB-4), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), AST to platelet count ratio (APRI), and platelet count to spleen diameter (PC/SD) ratio] compared to percutaneous liver biopsy to classify significant fibrosis, advanced fibrosis and cirrhosis in patients with autoimmune hepatitis. The authors showed that the PC/SD ratio correctly identifies autoimmune hepatitis patients with advanced fibrosis and cirrhosis, thereby decreasing the execution of liver biopsy in these patients.…”

A comparison of spleen size measured by ultrasound in a random population sample and a matched sample of patients at a university hospital, and the determination of normal values and influencing factors

“…Moreover, Abdullahi et al reported correlations between splenomegaly and lower values for MCV and MCH and higher values for MCHC, white blood cell count, reticulocyte count, and platelet count [28]. Various studies have found negative correlations between platelet count and spleen size, reported as the "platelet count to spleen length ratio" [8] and the "platelet count to spleen diameter ratio" [23]. These ratios can be used as diagnostic and prognostic parameters.…”

“…Data on the correlation of different laboratory parameters and spleen size is surprisingly sparse, although there are many conditions in which splenomegaly and pathologic laboratory parameters are common findings. Only the coherence between low platelet counts and an enlarged spleen ("Platelet count to spleen length" [22] and "Platelet count to spleen diameter ratio" [23]) is acknowledged in the daily routine in hospitals, referring to a condition called hypersplenism. Therefore, it seems important to define exact standard values for the spleen's size, including anthropometric factors and laboratory parameters.…”