28 ALBUMIN AND PROTHROMBIN TIME CORRELATE WITH THYROID FUNCTION IN CHILDREN WITH CHRONIC LIVER DISEASE

Transient prolongation of the prothrombin time was observed in the setting of a 10-g overdose of naproxen. The patient reported was previously healthy, without chronic liver disease, bleeding disorders, or malnutrition. The most likely mechanism for this effect is direct inhibition of the synthesis of vitamin-K-dependent clotting factors, possibly via production of “abnormal” prothrombin.

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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/415 ◽

2021 ◽

Vol 8 (25) ◽

pp. 2222-2228

Author(s):

Jasmine Kaur ◽

Navjot Kaur ◽

Jasleen Kaur ◽

Navjot Kaur Layal ◽

Gurkiran Kaur

Keyword(s):

Liver Cirrhosis ◽

Liver Disease ◽

Prothrombin Time ◽

Chronic Liver Disease ◽

Tertiary Care ◽

Meld Score ◽

Chronic Liver ◽

Care Hospital ◽

End Stage Liver Disease ◽

End Stage

BACKGROUND 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. METHODS 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 ChildTurcotte-Pugh (CTP) classification. RESULTS 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 profile. CONCLUSIONS 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. KEYWORDS Anaemia, Liver Cirrhosis, Model for End-Stage Liver Disease Score, Child-TurcottePugh Class

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Prothrombin time in patients with and without fibrotic chronic liver disease

The Internet Journal of Pathology ◽

10.5580/2623 ◽

2009 ◽

Vol 8 (1) ◽

Keyword(s):

Liver Disease ◽

Prothrombin Time ◽

Chronic Liver Disease ◽

Chronic Liver

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Study of association between chronic liver disease and thyroid function tests at a tertiary hospital

MedPulse International Journal of Physiology ◽

10.26611/1031911 ◽

2021 ◽

Vol 19 (1) ◽

pp. 01-04

Author(s):

S Bethiun ◽

Keyword(s):

Liver Cirrhosis ◽

Liver Disease ◽

Chronic Liver Disease ◽

Thyroid Function ◽

Tertiary Hospital ◽

Chronic Liver ◽

Thyroid Function Tests ◽

Alcoholic Liver Cirrhosis ◽

Free T4 ◽

Thyroid Profile

Background: Among the various functions of liver, one function is synthesis of carrier proteins and metabolism of hormones and liver diseases, have been shown to be associated with various endocrinal disturbances. Aim of the study was to evaluate the spectrum of chronic liver disease and association between thyroid profile and severity of liver damage at a tertiary hospital. Material and Methods: Present study was single-center, hospital based, case-control study, conducted in 88 cases of liver cirrhosis/ chronic liver disease and 88 age/sex matched healthy controls (randomly selected from relatives attending OPD with patients) were studied. Thyroid function tests were done and compared among cases and controls. Results: In present study 88 cases of liver cirrhosis/ chronic liver disease and 88 healthy controls were studied. Mean age and gender were comparable in cases and controls and difference was not statistically significant. Most of cases had alcoholic liver cirrhosis (80.7 %), rest had non-alcoholic liver cirrhosis (12.5%) and chronic viral hepatitis (6.8%). As per Child-Pugh Score, most cases were from Child-Pugh B (42%), followed by Child-Pugh C (31.8%) and Child-Pugh A (26.1%). In present study free T3, free T4 and TSH were compared between cases and controls, abnormal values were noted in cases and statistically significant difference was noted. Serum thyroid profile abnormalities were noted as per advancement in Child-Pugh Score Classes and difference was statistically significant for free T3 and free T4. Conclusion: Thyroid function test abnormalities in circulating thyroid hormone concentrations were noted in patients liver cirrhosis as compared to healthy subjects and severe abnormalities were associated with advanced Child Pugh score.

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Diagnostic Value of Routine Liver Tests

Clinical Chemistry ◽

10.1093/clinchem/21.1.71 ◽

1975 ◽

Vol 21 (1) ◽

pp. 71-75 ◽

Cited By ~ 25

Author(s):

Per Winkel ◽

Klavs Ramsøe ◽

Jørgen Lyngbye ◽

Niels Tygstrup

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Prothrombin Time ◽

Chronic Liver Disease ◽

Diagnostic Value ◽

Chronic Liver ◽

Misclassification Rate ◽

Alkaline Phosphatases ◽

Diagnostic Categories ◽

Liver Tests

Abstract In 131 patients on a medical service and 97 patients on a surgical service, in whom a diagnosis of hepatobiliary disease was verified in the hospital, the diagnostic value of routine liver tests performed soon after admission was evaluated by stepwise discriminant analysis. By measurements of alanine aminotransferase, alkaline phosphatases, gamma globulin, prothrombin time, bilirubin, and albumin, half of the medical patients were correctly classified into one of seven diagnostic categories. Aminotransferase contributed most to the classification, being twice as effective as random allocation. Decreasing the number of diagnostic categories to three (hepatitis, fatty liver, and chronic liver disease) increased the frequency of correct allocation to 80%. The allocation of all the patients to seven medical and four surgical diagnostic categories by means of four tests (aminotransferase, alkaline phosphatases, prothrombin time, and bilirubin) was significantly improved by each step, with a misclassification rate of 55% when all tests were used. A reduction of the diagnostic groups to five (hepatitis, fatty liver, chronic liver disease, duct obstruction and tumor) increased the frequency of correct allocation to 63%. The analysis demonstrates the limited diagnostic effectiveness of routine liver tests when used alone. The absolute discrimination values depend on the a priori frequencies of the diagnostic groups investigated, and therefore may vary from time to time and from place to place.

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