Prothrombine and activated partial thromboplastin time are prolonged in hepatic cirrhosis

Main Article Content

Edward Kurnia Setiawan Limijadi
Lisyani Budi Suromo
Imam Budiwiyono

Abstract

Background

Chronic hepatitis and hepatic cirrhosis are chronic liver diseases that cause disorders of liver function, such as the formation of platelets and coagulation factors (prothrombin time/PT and activated partial thromboplastin time/APTT). Chronic hepatitis in the long term can develop into hepatic cirrhosis. The aim of this study was to determine platelet count, PT, and APTT as indicators in the progression of chronic hepatitis towards hepatic cirrhosis.

 

Methods

A cross-sectional study was conducted on 50 patients with chronic hepatitis and hepatic cirrhosis in Semarang City Regional General Hospital, Telogorejo Hospital and Kariadi General Hospital. The platelet count was measured with a Sysmex XP-100, while PT and APTT was measured with a Sysmex CA-1500 coagulometer. The Mann Whitney test was applied to analyze the difference in platelet count, PT, and APTT between chronic hepatitis and hepatic cirrhosis.

 

Results

Median, minimum, and maximum values of platelet count, PT and APTT in chronic hepatitis were 284.000/µl, 210.000/µl, 390.000/µl; 10.6 sec, 9.5 sec, 13.6 sec; and 30.5 sec, 24.2 sec, 46.4 sec, respectively, and in hepatic cirrhosis they were 96.300/µl, 48.200/µl, 133.800/µl; 27.5 sec, 11.9 sec, 44.7 sec; and 55.6 sec, 31.3 sec, 72.0 sec, respectively. There was a significant difference the reduction of platelet count, and the prolongation of PT and APTT in chronic hepatitis compared to hepatic cirrhosis (p=0.000).

 

Conclusions

Prothrombine time and APTT were prolonged and platelet count was decreased in hepatic cirrhosis subjects. The three parameters may be used to evaluate the progression of chronic hepatitis towards hepatic cirrhosis.

Article Details

How to Cite
Limijadi, E. K. S., Suromo, L. B., & Budiwiyono, I. (2016). Prothrombine and activated partial thromboplastin time are prolonged in hepatic cirrhosis. Universa Medicina, 35(1), 26–32. https://doi.org/10.18051/UnivMed.2016.v35.26-32
Section
Original Articles

References

Ivanova L, Russev V. Chronic liver disease and parenterally transmitted hepatitis viruses. Eur J Inflamm 2007;5:1-6.

Ricardo R, Rui TM, Miguel S. Classification and staging of chronic liver disease from multimodal data. IEEE Trans Biomed Eng 2012;60:1336-44.

Guntur H. Perspektif masa depan imunologi infeksi. Surakarta: Sebelas Maret University Press; 2006.

Sherlock S, Dooley J, editors. Disease of the liver and biliary system. 11th ed. USA: Blackwell Science; 2002.

Hiromitsu H, Toru B, Ken S, et al. Management of throombocytopenia due to liver cirhosis: A Riview. World J Gastroenterol 2014;20:2595-605.

Olariu M, Olariu C, Olteanu D. Thrombocytopenia in chronic hepatitis C. J Gastrointestin Liver Dis 2010;19:381-5.

Sylvester CN, Obike I. Quantitative platelet abnormalities in patients with hepatitis B virus-related liver disease. Gastroenterol Res 2009;2:344-9.

Reverter JC. Abnormal hemostasis tests and bleeding in chronic liver disease: are they related? J Thromb Haemos 2006;4:717-20.

Tagwa YE, Fathelrahman MH. Assessment of platelets count and coagulation parameters among Sudanese patients with liver cirrhosis. RMJ 2013;38:215-8.

Ahmadhamed A, Samina N, Saeed S, et al. An assessment of coagulation parameters in liver cirrhosis. Biomedica 2006;22:74-7.

Dawson B, Trapp RG. Basic & clinical biostatistics. 4th ed. New York: Mc Graww Hill;2014.

Siemens. Thromborel S. Germany: Siemens 2008:1-2.

Sajjadieh M, Viunytska L. Prothrombin time in patients with and without fibrotic chronic liver disease. Int J Pathol 2008;8:1-5

Elzouki AN, Smeo MN, Sammud M, et al. Prevalence of hepatitis B and C virus infections and their related risk factors in Libya: a national seroepidemiological survey. East Mediterr Health J 2013;19:589-99.

Fawad K, Sulaiman S, Ihteshamud DQ, et al. Hepatitis B virus infection among different sex and age groups in Pakistani Punjab. Virology J 2011;8:1-5.

Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI. Riset kesehatan dasar (Riskesdas) Kementrian Kesehatan RI. Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2013.

Daniel HC. Chronic liver disease and cirrhosis deaths in California. California: California Department of Health Services; 2006.

Perhimpunan Peneliti Hati Indonesia (PPHI). Sirosis hepatis; 2013.

Rahmat H, Ramli HA, Elvie L. Hubungan gambaran USG pada penderita sirosis hati dengan fibrosis skor di Bagian Radiologi RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2013 – Desember 2013. E-Clinic; 2014;2:1-9.

Ratib S, West J, Crooks CJ, et al. Diagnosis of liver cirrhosis in England, a cohort study, 1998–2009: A comparison with cancer. Am J Gastroenterol 2014;109:190-8.

Kiah H, Syarif HD, Edhiwan P, et al. Penatalaksanaan hepatitis B kronik. Majour 2010;1:1-7.

Marc GG, Doris BS, David LT, et al. Hepatology: Diagnosis, management, and treatment of hepatitis C. An Update 2009;49:1335-74.

National Institute for Health and Care Excellence (NICE). Hepatitis B chronic. United Kingdom: Health and Social Care Directorate; 2013.

Kenneth ES. Perspective advanced liver disease: what every hepatitis C virus treater should know hepatitis. IAS-USA 2011;19:121-5.

Nezam A, John MH, Robert B, et al. Thrombocytopenia associated with chronic liver disease. J Hepatol 2008;48:1000-7.

Rafique AM, Badar A, Riaz AQ. The importance of abnormal coagulation tests and management of bleeding in chronic liver disease. MC 2011;17:65-8.

Bikha RD, Mir AAT, Aneela AR, et al. Coagulopathies in patients with liver cirrhosis. World Appl Sci J 2012;17:1-4.

Jody LK. Hemostatic defects in end stage liver disease. Crit Care Clin 2005;21:563-87.

Senzolo M, Burra P, Cholongitas E, et al. New insights into the coagulopathy of liver disease and liver transplantation. World J Gastroenterol 2006;12:7725-36.