ROLE OF ANTIPLATELET ANTIBODIES IN CHILDREN
WITH CHRONIC LIVER DISEASE
Hassanin B-M1, Khalifa S-G1, Behairy B-E2
and El-ShaarawyA-A2
1 Benha Faculty of Medecine, Benha, Egypt
2 National liver Institute, Menoufia, Egypt
A community based study for the incidence of
the circulating antiplatelet antibodies and anticardiolipin antibodies
(ACA- IgG) in children with Chronic liver diseases (CLD) and their relation
to the platelet count compared to cases with Idiopathic Thrombocytopenia
(ITP) and evaluating their practical significance in CLD patients compared
to normal controls.
Seventy two children were enrolled in this
study. They were classified into 3 main groups: Group I: 42 patients with
CLD, Group II: 15 patients with ITP and Group III: 15 healthy children as
controls. Univariate analysis showed that thrombocytopenia is significantly
associated with CLD of various etiologies in our children. Its incidence
and severity are significantly related to the incidence of liver cirrhosis
but not significantly related to the spleen size or the incidence of
bleeding manifestations. Antiplatelet antibodies and ACA-IgG are
significantly found in children with CLD of various etiology and their
levels are significantly related to the severity of liver disease (decompensated
cirrhosis) but not related to the platelet count, spleen size or the
incidence of compensated lover disease. While the ACA-IgG is significantly
correlated with the incidence of bleeding manifestations in CLD patients,
the antiplatelet antibodies are not. The incidence of thrombocytopenia,
positive antiplatelet antibodies and positive ACA-IgG are higher in
autoimmune hepatitis (AIH) than in other causes of CLD. This enhances the
concept that an immune-mediated mechanism is involved in the platelet destruction
and the development of thrombocytopenia in children with CLD as it does in
ITP patients.
So we recommend for further studies to evaluate
the clinical importance of ACAs in children with CLD.