liver induced thrombocytopenia

Q: What is the etiology behind liver induced thrombocytopenia?

Answer: Although it is a well known fact that liver impairment leads to thrombocytopenia but rarely its mechanism of action is elucidated. It is due to two major reasons. 

First, adequate liver production not only depends on bone marrow's hematopoietic stem cell function but also on thrombopoietin (TPO) production in the liver. In liver insufficiency TPO production goes down and so the number of platelets in the blood. 

 Second, hepatic insufficiency leads to compensatory splenomegaly. This hypersplenism causes sequestration of platelets further augmenting the thrombocytopenia.. 

#hepatology

#hematology

References:

1. Rios R, Sangro B, Herrero I, Quiroga J, Prieto J. The role of thrombopoietin in the thrombocytopenia of patients with liver cirrhosis. Am J Gastroenterol. 2005 Jun;100(6):1311-6. doi: 10.1111/j.1572-0241.2005.41543.x. PMID: 15929762.

2. Hanafiah M, Shahizon AM, Low SF, Shahrina MH. Severe thrombocytopenia due to hypersplenism treated with partial splenic embolisation. BMJ Case Rep. 2013 Jul 5;2013:bcr2013010163. doi: 10.1136/bcr-2013-010163. PMID: 23833091; PMCID: PMC3736271.