Abstract

A PROSPECTIVE CLINICAL STUDY OF HAEMATOLOGICAL DISORDERS IN CHRONIC LIVER DISEASE

Author(s): Ravilla Raja, Y. Vinod Babu

BACKGROUND Liver plays a major role in maintaining the haematological parameters in normal and maintain the haemostasis. Liver is the storage site for iron, B12 and folic acid, which are necessary for the normal haematopoiesis. Liver also secretes the clotting factors and the inhibitors and keep the haemostasis in equilibrium. Hepatocellular failure, portal hypertension and jaundice may affect the blood picture. Chronic liver disease is usually accompanied by hypersplenism. Diminished erythrocyte survival is frequent. In addition, both parenchymal hepatic disease and cholestatic jaundice may produce blood coagulation defects. Dietary deficiencies, alcoholism, bleeding and difficulties in hepatic synthesis of proteins used in blood formation or coagulation add to complexity of the problem. MATERIALS AND METHODS To assess the haematological abnormalities in chronic liver disease, the prevalence study was conducted in Konaseema Institute of Medical Sciences, Amalapuram, during the period from June 2015 to August 2017. All blood investigations regarding haematological profile were done in clinical pathology laboratory in Konaseema Institute of Medical Sciences. Some investigations such as MCV, MCH and MCHC were done at outside lab, when the kit for testing was not available along with all other haematological profiles to have some control and to prevent the observers error if done separately. RESULTS The analysis of WBCs were done with the total count and the differential count. The total count of WBCs range from 1050/mm3 to 16,100/mm.3 Among 100 patients, only 14% had total proteins more than 6 gm% and only one patient had total protein <4 gm% and others in the middle group. 42% patients had protein in the range of 6-5 gm% and 43% had 5-4 gm% protein range. CONCLUSION According to this study conducted with a limited cases of 100 patients, we inferred many conclusive results regarding the haematological and haemostatic abnormalities in a decompensated chronic liver disease patients. In this study, more than 80% of the patients had total protein less than normal and almost 100% of patients had albumin-globulin ratio reversal.