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Haematological Abnormalities in Hepatic Cirrhosis in Children
Author(s) -
Sjölin Stig,
Foconi Severino
Publication year - 1964
Publication title -
scandinavian journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0036-553X
DOI - 10.1111/j.1600-0609.1964.tb00009.x
Subject(s) - leukopenia , medicine , red cell , erythropoiesis , splenectomy , ineffective erythropoiesis , macrocytosis , cirrhosis , reticulocyte , gastroenterology , anemia , bone marrow , microcytosis , iron deficiency , spleen , toxicity , biology , biochemistry , messenger rna , gene
Haematological studies are presented on sixteen children with cirrhosis of the liver. Slight to moderate anaemia was found in six patients. An increased total plasma volume caused apparent anaemia in four patients. Macrocytosis of unknown aetiology was found in fourteen. The cause and mechanism of the anaemia varied, and in some patients several factors contributed to it. The mean red‐cell life span was shortened in fifteen patients, and evidence is presented that hyperhaemolysis was mainly due to increased splenic sequestration of red cells. In at least eight patients erythropoiesis was sufficient to compensate for the increased red‐cell destruction, but in five the bone‐marrow response to anaemia was below normal with respect to the output of viable red cells. In one patient a low red‐cell production was probably the only cause of anaemia. The “absolute reticulocyte count” was approximately proportional to the effective red‐cell production in ten patients, but in four the reticulocyte count was increased and the effective red cell production normal. The results of radioiron and survival studies also indicated ineffective erythropoiesis in four patients. This finding probably signifies intrinsic red‐cell defects. Bleeding from the gastrointestinal tract and iron deficiency probably contributed to the anaemia of some patients. Hyperhaemolysis was associated with leukopenia, thrombocytopenia, and splenomegaly infive patients, and with thrombocytopenia and splenomegaly in three. The finding that leukopenia and thrombocytopenia disappeared immediately after splenectomy in all six patients so treated indicates that the leukopenia and thrombocytopenia were due to hypersplenism.