Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis.
<h4>Background</h4>Asplenia or functional hyposplenism are risk factors for severe infections, and vaccinations against encapsulated bacteria are advised. There are only limited data regarding the spleen function of cirrhotic patients.<h4>Methods</h4>We evaluated spleen funct...
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0271541&type=printable |
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| author | Malte H Wehmeyer Harsha Sekhri Raluca Wroblewski Antonio Galante Thomas Meyer Ansgar W Lohse Julian Schulze Zur Wiesch |
| author_facet | Malte H Wehmeyer Harsha Sekhri Raluca Wroblewski Antonio Galante Thomas Meyer Ansgar W Lohse Julian Schulze Zur Wiesch |
| author_sort | Malte H Wehmeyer |
| collection | DOAJ |
| description | <h4>Background</h4>Asplenia or functional hyposplenism are risk factors for severe infections, and vaccinations against encapsulated bacteria are advised. There are only limited data regarding the spleen function of cirrhotic patients.<h4>Methods</h4>We evaluated spleen function in patients with liver cirrhosis, who were prospectively enrolled in this study. Spleen function was evaluated by the measurement of pitted erythrocytes. Functional hyposplenism was defined as a percentage of PE of >15%.<h4>Results</h4>117 patients, mean age 58.4 years and 61.5% (n = 72) male with liver cirrhosis were included. Functional hyposplenism was diagnosed in 28/117 patients (23.9%). Pitted erythrocytes correlated with albumin (p = 0.024), bilirubin (p<0.001), international normalized ratio (INR; p = 0.004), model of end-stage liver disease (MELD) score (p<0.001) and liver stiffness (p = 0.011). Patients with functional hyposplenism had higher MELD scores (median 13 vs. 10; p = 0.021), liver stiffness (46.4 kPa vs. 26.3 kPa; p = 0.011), INR (1.3 vs. 1.2; p = 0.008) and a higher Child-Pugh stage (Child C in 32.1% vs. 11.2%; p = 0.019) as compared to patients without functional hyposplenism. Functional hyposplenism was not associated with the etiology of cirrhosis. Importantly, 9/19 patients with Child C cirrhosis had functional hyposplenism.<h4>Conclusion</h4>A quarter of patients with liver cirrhosis and almost 50% of patients with Child C cirrhosis have functional hyposplenism. Functional hyposplenism is associated with poor liver function and the degree of portal hypertension, which is characterized by higher liver stiffness measurements in transient elastography. |
| format | Article |
| id | doaj-art-2ec5af0eae6d4d56ad7fd42da66a61c6 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-2ec5af0eae6d4d56ad7fd42da66a61c62025-08-20T03:01:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01177e027154110.1371/journal.pone.0271541Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis.Malte H WehmeyerHarsha SekhriRaluca WroblewskiAntonio GalanteThomas MeyerAnsgar W LohseJulian Schulze Zur Wiesch<h4>Background</h4>Asplenia or functional hyposplenism are risk factors for severe infections, and vaccinations against encapsulated bacteria are advised. There are only limited data regarding the spleen function of cirrhotic patients.<h4>Methods</h4>We evaluated spleen function in patients with liver cirrhosis, who were prospectively enrolled in this study. Spleen function was evaluated by the measurement of pitted erythrocytes. Functional hyposplenism was defined as a percentage of PE of >15%.<h4>Results</h4>117 patients, mean age 58.4 years and 61.5% (n = 72) male with liver cirrhosis were included. Functional hyposplenism was diagnosed in 28/117 patients (23.9%). Pitted erythrocytes correlated with albumin (p = 0.024), bilirubin (p<0.001), international normalized ratio (INR; p = 0.004), model of end-stage liver disease (MELD) score (p<0.001) and liver stiffness (p = 0.011). Patients with functional hyposplenism had higher MELD scores (median 13 vs. 10; p = 0.021), liver stiffness (46.4 kPa vs. 26.3 kPa; p = 0.011), INR (1.3 vs. 1.2; p = 0.008) and a higher Child-Pugh stage (Child C in 32.1% vs. 11.2%; p = 0.019) as compared to patients without functional hyposplenism. Functional hyposplenism was not associated with the etiology of cirrhosis. Importantly, 9/19 patients with Child C cirrhosis had functional hyposplenism.<h4>Conclusion</h4>A quarter of patients with liver cirrhosis and almost 50% of patients with Child C cirrhosis have functional hyposplenism. Functional hyposplenism is associated with poor liver function and the degree of portal hypertension, which is characterized by higher liver stiffness measurements in transient elastography.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0271541&type=printable |
| spellingShingle | Malte H Wehmeyer Harsha Sekhri Raluca Wroblewski Antonio Galante Thomas Meyer Ansgar W Lohse Julian Schulze Zur Wiesch Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis. PLoS ONE |
| title | Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis. |
| title_full | Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis. |
| title_fullStr | Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis. |
| title_full_unstemmed | Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis. |
| title_short | Frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis. |
| title_sort | frequent detection of functional hyposplenism via assessment of pitted erythrocytes in patients with advanced liver cirrhosis |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0271541&type=printable |
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