A Study on Haematological Manifestations in Patients with Chronic Liver Disease in a Tertiary Care Hospital of North India


Jasmine Kaur1, Navjot Kaur2, Jasleen Kaur3, Navjot Kaur Layal4, Gurkiran Kaur5

Chronic liver diseases frequently are associated with haematological abnormalities.
Anaemia occurs in about 75% of patients with chronic liver disease. The most
common type of anaemia seen in liver cirrhosis is normocytic normochromic
anaemia, due to the chronic inflammatory state, blood loss from oesophageal and
rectal varices. The purpose of this study was to study the haematological
manifestations in patients with chronic liver disease.
A cross-sectional observational study was conducted at Sri Guru Ram Das Institute
of Medical Sciences and Research (March 2019 - March 2020). Total of 90 patients
with chronic liver disease were included in the study. The population was divided
into 2 groups based on the model for end-stage liver disease (MELD) score and
the various haematological abnormalities were assessed in these 2 groups.
Similarly, haemoglobin (Hb) levels were assessed in 3 groups based on the Child-
Turcotte-Pugh (CTP) classification.
There was a significant correlation between hemoglobina and CTP class (P <
0.001), with the lowest haemoglobin levels in CTP class C group. The correlation
coefficient of MELD score and haemoglobin was -0.504 which was significant
statistically. Thus, confirming the fact that haemoglobin levels decreases with the
progress in the severity of liver cirrhosis. Of 39 patients with haemoglobin < 8
g/dl, 5 (12.8 %) had a MELD score of < 12, whereas 34 patients (87.2 %) had a
MELD score of > 12 and was statistically significant (P < 0.0001). Leukocytosis
was observed in 41 patients and leucopoenia in 14 patients. The mean
prothrombin time was 20.4 seconds and 80 % of the patients had prothrombin
time prolonged by more than 6 sec indicating liver damage alters coagulation
We found an association between anaemia and indicators of advanced liver
disease such as a higher MELD and CPS scores. This study inferred that levels of
haemoglobin decrease as the severity of liver disease progresses. Thus, this
measure can be used in the initial assessment of cirrhosis patients that needs
urgent identification and correction to reduce morbidity and mortality.