A STUDY OF HEMATOLOGICAL PROFILES IN CHRONIC LIVER DISEASE WITH SPECIAL REFERENCE TO ANEMIA, THROMBOCYTOPENIA, AND LEUKOPENIA
Main Article Content
Keywords
chronic liver disease; anemia; thrombocytopenia; leukopenia; peripheral smear
Abstract
Introduction:
Chronic liver disease (CLD) is a progressive disorder associated with significant morbidity and mortality due to hepatic and extrahepatic complications. Hematological abnormalities such as anemia, thrombocytopenia, and leukopenia are frequent in CLD and often correlate with disease severity. These simple, cost-effective parameters may provide valuable insight into prognosis and clinical outcomes, especially in resource-limited settings.
Aim and Objective:
This study aimed to evaluate the hematological profile of CLD patients, with special reference to the prevalence and patterns of anemia, thrombocytopenia, and leukopenia, and to assess their correlation with clinical features and disease severity.
Materials and Methods:
A prospective cohort study was conducted in the Department of General Medicine, G.R. Medical College, Gwalior, from April 2023 to September 2024. One hundred patients aged 18–60 years with CLD confirmed by ultrasonography were enrolled using purposive sampling. Patients with comorbidities, pregnancy, or prior anemia treatment were excluded. Hematological indices, peripheral smear findings, and biochemical parameters were recorded and statistically analyzed.
Results:
Moderate anemia was most common (37%), followed by severe (20%) and mild (16%). Normocytic normochromic morphology predominated (45%), with macrocytic and microcytic variants also present. Thrombocytopenia occurred in 52%, significantly associated with severe anemia (p < 0.001) and complications like hematemesis and ascites. Leukopenia was infrequent, while mortality reached 12%. Hypoalbuminemia showed strong correlation with advanced disease severity, underscoring its prognostic value.
Conclusion:
Anemia and thrombocytopenia are highly prevalent in CLD and correlate with clinical severity. Peripheral smear analysis remains a valuable, low-cost diagnostic adjunct. Hematological profiling should be integrated into routine CLD management for early risk stratification and prognostic evaluation.
References
2. Balakrishnan M, Rehm JJH. A public health perspective on mitigating the global burden of chronic liver disease. 2024;79(2):451-9.
3. Bergasa NV. Approach to the patient with liver disease. Clinical Cases in Hepatology: Springer; 2021. p. 5-26.
4. Elsabaawy M, Alhaddad OJGRPG. Forgettable in the care of liver cirrhosis: the unseen culprits of progression from bad to worse. 2024;19(1):6-17.
5. Udompap P, Kim D, Kim WRJCG, Hepatology. Current and future burden of chronic nonmalignant liver disease. 2015;13(12):2031-41.
6. Huang DQ, Terrault NA, Tacke F, Gluud LL, Arrese M, Bugianesi E, et al. Global epidemiology of cirrhosis—aetiology, trends and predictions. 2023;20(6):388-98.
7. Sureka B, Bansal K, Patidar Y, Rajesh S, Mukund A, Arora AJCpidr. Neurologic manifestations of chronic liver disease and liver cirrhosis. 2015;44(5):449-61.
8. Shroff H, Gallagher HJCT. Multidisciplinary care of alcohol-related liver disease and alcohol use disorder: a narrative review for hepatology and addiction clinicians. 2023;45(12):1177-88.
9. Casey GJKTNNZ. Diseases of the liver. 2016;22(11):20.
10. Marks PW, editor Hematologic manifestations of liver disease. Seminars in hematology; 2013: Elsevier.
11. Trikha A, Ray BR. Pathophysiology of chronic liver disease. Peri-operative anesthetic management in liver transplantation: Springer; 2023. p. 51-62.
12. Kirchner IM, Gallicchio VSJJCRCS. Hematological Clues to Alcohol Use Disorder: The Diagnostic Significance of Basophilic Stippling & Macrocytosis in Vitamin Deficiency-Related Anemia. 2025;3(3):1-8.
13. Cheemerla S, Balakrishnan MJCld. Global epidemiology of chronic liver disease. 2021;17(5):365-70.
14. Sankar V, Villa AJBsOM. Hematologic diseases. 2021:627-64.
15. Aiza-Haddad I, Cisneros-Garza L, Morales-Gutiérrez O, Malé-Velázquez R, Rizo-Robles M, Alvarado-Reyes R, et al. Guidelines for the management of coagulation disorders in patients with cirrhosis. 2024;89(1):144-62.
16. Joshi D, Akram M, Das K, Kala M, Joshi Jr DJC. A cross-sectional study of the haematological profile of patients with chronic liver disease (CLD). 2023;15(6).
17. Scheiner B, Semmler G, Maurer F, Schwabl P, Bucsics TA, Paternostro R, et al. Prevalence of and risk factors for anaemia in patients with advanced chronic liver disease. 2020;40(1):194-204.
18. Patel N, Shah NJJMSCR. A prospective study of anemia profile of chronic liver diseases patients. 2017;5:18144-7.
19. Krishnegowda M, Rajashekaraiah VJBC, Fibrinolysis. Platelet disorders: an overview. 2015;26(5):479-91.
20. Allison MG, Shanholtz CB, Sachdeva AJCCC. Hematological issues in liver disease. 2016;32(3):385-96.
21. Sarangi R, Raman S, Padhi S, Thakur B. Evaluation of Biochemical, Haematological Parameters and Noninvasive Prognostic Scores in Alcoholic Liver Disease with and without Complications.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr.Manjeet Singh
Junior Resident Dept. of Medicine, GRMC Gwalior, M.P., India
Dr.Ajay Pal Singh
Professor, Dept. of Medicine, GRMC Gwalior, India
Dr.Vedant Sharma
Assistant Professor, Dept. of Medicine, Ssjgimsr India