RESUMO
Background: Chronic hepatitis C virus infection are often associated with extra hepatic imrnunological manifestations including various autoimmune disorders . The aim of this study was to evaluate the significance of immune thrombocytopenia and platelet associated IgG in patients with chronic hepatitis C and patients with liver cirrhosis .Forty patients with chronic hepatitis C virus infection were chosen for this study . They were divided according to platelet cotmt into thrombocytopenic group and non thrombocytopenic group matched for age and sex .all patients were subjected to liver function tests , renal function tests , complete blood picture, bone marrow biopsy ,abdominal ultrasonography , liver biopsy with histopathological examination and platelet Ig G assay[PA Ig G]
Results: PA IgG was significantly high in thrombocytopenic group [15 out of 20 ; 75%] compared with non thrombocytopenic group [3 out of 20 ,15%][p< 0.01] . Moreover , in the thrombocytopenic group,when we compared PAIgG and child's grades we found that PAIgG was significantly high in patients with child's C grade [6 out- of 6 100%], when compared to child's B'[4 out of 7 ; 57%], and those with child's A [0 out of 7Also PAIgG was significantly high in patients with child's B when compared with those with child's A grade[p<0.05]. As regards histopathology index , we found that in the thrombocytopenic group , PAIgG was significantly high in patients with liver cirrhosis [8. out of 10;.80%] compared with chronic active hepatitis[2 out of 10 ;20%][p< 0.01]. Moreover , we found that histopathological activity index was significantly high in the thrombocytopenic group [9.1+ 2.5] comparing with non-thrombocytopenic group [7.35 +2.5][p,0.05] . Also fibrosis stage was significantly high in the thrombocytopenic group [2.5+0.96] , comparing to non thrombocytopenic group [2.05+0.876][p< 0.05]. the study
Concluded: that It is vitally important not to immediately conclude that the thrombocytopenia encountered in patients with chronic hepatitis C indicates cirrhosis with portal hypertension andhypersplenism, but autoimmune mechanisms may be the cause. PAIgG and immune thrombocytopenia can be used as prognostic marker from the clinical and pathological point of view in patients with chronic hepatitis C virus infection and in patients with liver cirrhosis passing from one stage to another
RESUMO
Dyspepsia is a frequent symptom in cirrhotic patients. Congestive gastropathy or portal hypertensive gastropathy [PHG] was detected as a possible cause of sustained dyspepsia in 40% of these patients, and prolonged gastric emptying time [GE] with decrease gastric wall compliance were detected in cirrhoric patients. Electrogastrography [EGG] is a non-invasive method to study gastric myoelectrical activity from the body surface by electrodes. whereas, an ultrasonographic method can be used for the estimation of gastric emptying by measuring what so called half emptying and full emptying times with other parameters. Aim of this work is to study patterns of EGG and ultrasnographic GE. In cirrhotic patients with or without PHG. 45 patients were chosen for this study and were divided into 3 groups ; group 1 is cirrhotic patients with PHG negative upper gastrointestinal [U.G.I.T.] endoscopy and group 2 is cirrhotic patients with PHG positive and group 3 is healthy subjects taken as control. We found significant delay in GE in gp. 2 in relation to group 3 [p < 0.05]. EGG reveiled power ratio lower in gp. 1, 2 [2.01 - 1.93] respectively compared to group. 3 [2.63]. Also there was highly significint increase in "Dominant frequency" at rest [DF] in group.1 campared to group. 2 and 3 [p>0.01] where mean of group 1 was 2944.9, in group 2 was 2477 and in group 3 was 1934 and the power meal at DF was higher in group 1 than 2 , 3 but siatistically insignificant where the mean in group 1 was 5922.5 and in group. 2 was 4804.8 and was 5087.8 in group 3 [p>0.05]. Delayed gastric emptying by U.S, and changes in EGG records of cirrohotic patients especially in presence of portal hypertensive gastropathy may explain dyspepsia frequently occurring with portal hypertensive gastropathy