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Thrombocytopenia in Chronic Liver Disease: Challenges and Treatment Strategies

Shreya Desai1, Anita Subramanian2,3

  • 1Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, USA.

Cureus
|July 19, 2021
PubMed

Insights

Thrombocytopenia, a low platelet count, is common in chronic liver disease (CLD). This review covers causes and treatments, including new thrombopoietin receptor agonists for improving platelet levels.

Area of Science:

  • Hematology
  • Hepatology
  • Internal Medicine

Background:

  • Thrombocytopenia is a frequent hematologic complication in patients with chronic liver disease (CLD).
  • Its pathophysiology is multifactorial, involving platelet sequestration in the spleen and reduced platelet production.
  • Understanding these mechanisms is crucial for effective management.

Purpose of the Study:

  • To review the pathophysiology of thrombocytopenia in chronic liver disease.
  • To discuss current and emerging treatment options for this condition.
  • To highlight the role of new therapies in managing platelet counts in CLD patients.

Main Methods:

  • Literature review of studies on thrombocytopenia in chronic liver disease.
  • Analysis of pathophysiological mechanisms.
  • Evaluation of current and novel treatment strategies.

Main Results:

  • Platelet sequestration and decreased production are key pathophysiological factors.
  • Platelet transfusions remain a standard treatment.
  • Transjugular intrahepatic portosystemic shunt (TIPS) and splenic artery embolization offer alternative management options.
  • Thrombopoietin receptor agonists (TPO-RAs) have emerged as a safe and effective treatment.

Conclusions:

  • Thrombocytopenia in CLD requires a multifactorial approach to management.
  • TPO-RAs represent a significant advancement, improving platelet levels and reducing transfusion dependency.
  • Further research may explore optimizing TPO-RA use in specific CLD patient populations.

Keywords:
blood transfusionchronic liver disease (cld)cirrhosisthrombocytopeniatipstpo receptor agonist

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