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Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy
BACKGROUND/AIM: Thrombocytopenia is a common finding in patients with cirrhosis and may lead to unnecessary referral for bone marrow (BM) biopsy. To date, the prevalence of cirrhosis in patients with thrombocytopenia who receive BM biopsy is largely unknown. MATERIALS AND METHODS: Between fiscal yea...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409887/ https://www.ncbi.nlm.nih.gov/pubmed/22824769 http://dx.doi.org/10.4103/1319-3767.98431 |
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author | Sheikh, Muhammad Y. Raoufi, Rahim Atla, Pradeep R. Riaz, Muhammad Oberer, Chad Moffett, Michael J. |
author_facet | Sheikh, Muhammad Y. Raoufi, Rahim Atla, Pradeep R. Riaz, Muhammad Oberer, Chad Moffett, Michael J. |
author_sort | Sheikh, Muhammad Y. |
collection | PubMed |
description | BACKGROUND/AIM: Thrombocytopenia is a common finding in patients with cirrhosis and may lead to unnecessary referral for bone marrow (BM) biopsy. To date, the prevalence of cirrhosis in patients with thrombocytopenia who receive BM biopsy is largely unknown. MATERIALS AND METHODS: Between fiscal years 2006-2010, 744 patients (≥18 years) who underwent BM biopsies for thrombocytopenia at our hospital were identified retrospectively. 541 patients were excluded who had hematologic malignancies and received chemotherapy. Remaining 203 patients with predominant isolated thrombocytopenia were included in the study. RESULTS: Of 203 patients, 136 (67%) had a normal and 67 (33%) had an abnormal BM examination. Prevalence of cirrhosis in the study population was 35% (95% CI: 28.4-41.9). 51% patients with normal BM were found to have cirrhosis compared to 3% of patients with abnormal BM exam (P < 0.0001). Common causes of cirrhosis were nonalcoholic steatohepatitis (NASH) (47%), followed by alcohol and Hepatitis C virus infection. Idiopathic thrombocytopenia and myelodysplastic syndrome were most frequent causes of thrombocytopenia in patients without cirrhosis. Patients with NASH had higher body mass index (BMI) (33.4 vs. 25.8, P < 0.001) and lower MELD scores (11.1 vs. 16, P = 0.028) when compared to non-NASH patients with cirrhosis. CONCLUSION: Approximately, one third (35%) of patients with cirrhosis induced thrombocytopenia may undergo unwarranted BM biopsies. Clinical diagnosis of cirrhosis is still a challenge for many physicians, particularly with underlying NASH. We propose cirrhosis to be the prime cause of isolated thrombocytopenia. |
format | Online Article Text |
id | pubmed-3409887 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-34098872012-08-03 Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy Sheikh, Muhammad Y. Raoufi, Rahim Atla, Pradeep R. Riaz, Muhammad Oberer, Chad Moffett, Michael J. Saudi J Gastroenterol Original Article BACKGROUND/AIM: Thrombocytopenia is a common finding in patients with cirrhosis and may lead to unnecessary referral for bone marrow (BM) biopsy. To date, the prevalence of cirrhosis in patients with thrombocytopenia who receive BM biopsy is largely unknown. MATERIALS AND METHODS: Between fiscal years 2006-2010, 744 patients (≥18 years) who underwent BM biopsies for thrombocytopenia at our hospital were identified retrospectively. 541 patients were excluded who had hematologic malignancies and received chemotherapy. Remaining 203 patients with predominant isolated thrombocytopenia were included in the study. RESULTS: Of 203 patients, 136 (67%) had a normal and 67 (33%) had an abnormal BM examination. Prevalence of cirrhosis in the study population was 35% (95% CI: 28.4-41.9). 51% patients with normal BM were found to have cirrhosis compared to 3% of patients with abnormal BM exam (P < 0.0001). Common causes of cirrhosis were nonalcoholic steatohepatitis (NASH) (47%), followed by alcohol and Hepatitis C virus infection. Idiopathic thrombocytopenia and myelodysplastic syndrome were most frequent causes of thrombocytopenia in patients without cirrhosis. Patients with NASH had higher body mass index (BMI) (33.4 vs. 25.8, P < 0.001) and lower MELD scores (11.1 vs. 16, P = 0.028) when compared to non-NASH patients with cirrhosis. CONCLUSION: Approximately, one third (35%) of patients with cirrhosis induced thrombocytopenia may undergo unwarranted BM biopsies. Clinical diagnosis of cirrhosis is still a challenge for many physicians, particularly with underlying NASH. We propose cirrhosis to be the prime cause of isolated thrombocytopenia. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3409887/ /pubmed/22824769 http://dx.doi.org/10.4103/1319-3767.98431 Text en Copyright: © Saudi Journal of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Sheikh, Muhammad Y. Raoufi, Rahim Atla, Pradeep R. Riaz, Muhammad Oberer, Chad Moffett, Michael J. Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy |
title | Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy |
title_full | Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy |
title_fullStr | Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy |
title_full_unstemmed | Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy |
title_short | Prevalence of Cirrhosis in Patients with Thrombocytopenia Who Receive Bone Marrow Biopsy |
title_sort | prevalence of cirrhosis in patients with thrombocytopenia who receive bone marrow biopsy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409887/ https://www.ncbi.nlm.nih.gov/pubmed/22824769 http://dx.doi.org/10.4103/1319-3767.98431 |
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