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Background and aim: Thrombocytopenia is a common complication of chronic liver diseases and is due to various causes.The effect of thrombocytopenia on liver damage and the exact mechanisms that lead to thrombocytopenia in chronic liver disease and cirrhosis are still unclear. As Platelets Derived Growth Factor ß (PDGF-ß) is released from platelets (PLTs) upon activation. We tried to identify PLTs and PDGFRß in the liver to shed some light on the pathophysiology of thrombocytopenia and liver fibrosis in chronic hepatic C patients. Patients and Methods: Analytical cross-sectional study was conducted on fifty patients with proven chronic hepatitis C. All patients were referred to Tropical Medicine and Gastroenterology Department, Sohag University Hospital. Patients were categorized into two groups. Group 1 includes patients with PLT count less than 150000/μL (thrombocytopenia). Group 2 includes patients with normal PLT count (150000-450000/μL). All patients were subjected to full history taking, complete clinical examination, complete blood count, liver function tests. Liver biopsy was obtained for histological staging and grading. Immunohistochemical study of PLTs and PDGFRß were done using monoclonal antibodies against PLT's surface marker CD41 and PDGFRß. Results: The included patients were 80 % males and 20 % females. Their mean age was 44.42± 11.17 years. The mean average weighted score (AWS) of Imunohisto-chemical expression of CD41was significantly higher in thrombocytopenic group compared to normal PLTs group (5.8±2.86 vs 3.43±3.03; P<0.001). There was a significant negative correlation between CD41 expression and peripheral PLT count (r=-0.4; P=0.007). PDGFRß expression was significantly stronger in thrombocytopenic patients than patients with normal PLT count (6.9±3.6 vs 5.27±3.92; P=0.001). It showed also a significant negative correlation with peripheral PLT count (r=-0.34, P=0.045). Both CD41 and PDGFRß expression were significantly elevated in patients with advanced stage of fibrosis than in those with earlier stages (7.26±5.23 vs 5.88±3.24; P=0.04 &9.2±2.7 vs 6.7±3.6; P<0.01 respectively). Conclusion: The accumulation of PLTs in the liver in patients with chronic hepatitis C may be involved in thrombocytopenia and liver fibrosis.

Platelets Accumulation In The Liver : A novel Mechanism Of Thrombocytopenia In Chronic Hepatic C Patients