Brief Communication Acta Haematol 2014;132:159–162 DOI: 10.1159/000357934
Received: October 28, 2013 Accepted after revision: December 12, 2013 Published online: February 21, 2014
Nonalcoholic Fatty Liver Disease May Cause Thrombocytopenia Guillermo J. Ruiz-Argüelles a–d Sara Velazquez-Sanchez-De-Cima a, c Gabriela Zamora-Ortiz a, d Jesús Hernandez-Reyes a, e Guillermo J. Ruiz-Delgado a, b, d a
Centro de Hematología y Medicina Interna de Puebla, b Laboratorios Clínicos de Puebla, Universidad Popular Autónoma del Estado de Puebla and d Universidad de las Américas Puebla, Puebla, and e Universidad del Valle de México, Campus Villahermosa, Villahermosa, Mexico c
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver injury worldwide [1]. It covers a wide spectrum of hepatic disorders ranging from simple steatosis and steatohepatitis (steatosis with inflammation) to liver cirrhosis. The molecular and cellular mechanisms underlying hepatic injury in NAFLD are not clear. There is evidence to suggest that multiple mechanisms including insulin resistance, oxidative stress, inflammation and genetic factors interact to initiate the development of NAFLD [1]. Thrombocytopenia has been described in some cases of NAFLD [2–4], but its prevalence and salient features have not been fully described. Currently, the diagnosis of NAFLD requires liver biopsy, an invasive procedure not free from potential complications; however, several noninvasive diagnostic strategies have been proposed as potential diagnostic alternatives, each with different sensitivities and accuracies [5–7]. Among the noninvasive alternatives to liver biopsy, several studies have demonstrated the predictive value and a better benefit-to-risk ratio than biopsy of combinations of simple serum biochemical markers [5]. In an effort to define some features of the thrombocytopenia that occurs in NAFLD, we prospectively studied 2 groups of individuals: patients with NAFLD defined by © 2014 S. Karger AG, Basel 0001–5792/14/1322–0159$39.50/0 E-Mail [email protected] www.karger.com/aha
noninvasive methods and patients with thrombocytopenia. Individuals who were consecutively referred to our clinic after March 2008 due to thrombocytopenia (platelet count 50% in either the SteatoTest or the NashTest coupled with a score of
Received: October 28, 2013 Accepted after revision: December 12, 2013 Published online: February 21, 2014
Nonalcoholic Fatty Liver Disease May Cause Thrombocytopenia Guillermo J. Ruiz-Argüelles a–d Sara Velazquez-Sanchez-De-Cima a, c Gabriela Zamora-Ortiz a, d Jesús Hernandez-Reyes a, e Guillermo J. Ruiz-Delgado a, b, d a
Centro de Hematología y Medicina Interna de Puebla, b Laboratorios Clínicos de Puebla, Universidad Popular Autónoma del Estado de Puebla and d Universidad de las Américas Puebla, Puebla, and e Universidad del Valle de México, Campus Villahermosa, Villahermosa, Mexico c
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver injury worldwide [1]. It covers a wide spectrum of hepatic disorders ranging from simple steatosis and steatohepatitis (steatosis with inflammation) to liver cirrhosis. The molecular and cellular mechanisms underlying hepatic injury in NAFLD are not clear. There is evidence to suggest that multiple mechanisms including insulin resistance, oxidative stress, inflammation and genetic factors interact to initiate the development of NAFLD [1]. Thrombocytopenia has been described in some cases of NAFLD [2–4], but its prevalence and salient features have not been fully described. Currently, the diagnosis of NAFLD requires liver biopsy, an invasive procedure not free from potential complications; however, several noninvasive diagnostic strategies have been proposed as potential diagnostic alternatives, each with different sensitivities and accuracies [5–7]. Among the noninvasive alternatives to liver biopsy, several studies have demonstrated the predictive value and a better benefit-to-risk ratio than biopsy of combinations of simple serum biochemical markers [5]. In an effort to define some features of the thrombocytopenia that occurs in NAFLD, we prospectively studied 2 groups of individuals: patients with NAFLD defined by © 2014 S. Karger AG, Basel 0001–5792/14/1322–0159$39.50/0 E-Mail [email protected] www.karger.com/aha
noninvasive methods and patients with thrombocytopenia. Individuals who were consecutively referred to our clinic after March 2008 due to thrombocytopenia (platelet count 50% in either the SteatoTest or the NashTest coupled with a score of
