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肝硬化患者外周血细胞减少原因不明时的骨髓评估

Bone Marrow Assessment in Liver Cirrhosis Patients with Otherwise Unexplained Peripheral Blood Cytopenia.

作者信息

Koschade Sebastian E, Moser Laura M, Sokolovskiy Artur, Michael Florian A, Serve Hubert, Brandts Christian H, Finkelmeier Fabian, Zeuzem Stefan, Trebicka Jonel, Ferstl Philip, Ballo Olivier

机构信息

Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.

Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.

出版信息

J Clin Med. 2023 Jun 29;12(13):4373. doi: 10.3390/jcm12134373.

Abstract

We performed a retrospective single-center analysis to investigate the diagnostic yield of bone marrow puncture in patients with liver cirrhosis and cytopenia. Liver cirrhosis patients receiving bone marrow aspiration or biopsy for the diagnostic work-up of otherwise unexplained peripheral blood cytopenia at our institution between 2004 and 2020 were enrolled in this study. We evaluated findings from cytologic, histologic and immunologic assessment and final diagnostic outcomes. A total of 118 patients with a median age of 55 years and a median Child-Pugh score of B (8 points) were enrolled. The main etiologies of liver cirrhosis were viral hepatitis (B and C) or chronic alcohol consumption. The majority of patients (60%) exhibited concurrent anemia, leukocytopenia and thrombocytopenia. Bone marrow assessment revealed normal, unspecific or reactive alterations in 117 out of 118 patients (99%). One patient was diagnosed with myelodysplastic syndrome. Our findings suggest that peripheral blood cytopenia in patients with liver cirrhosis is rarely associated with a primary bone marrow pathology.

摘要

我们进行了一项回顾性单中心分析,以研究肝硬化合并血细胞减少患者骨髓穿刺的诊断价值。2004年至2020年间,在我们机构接受骨髓穿刺或活检以诊断不明原因外周血细胞减少的肝硬化患者纳入本研究。我们评估了细胞学、组织学和免疫学评估结果以及最终诊断结果。共纳入118例患者,中位年龄55岁,Child-Pugh评分中位数为B级(8分)。肝硬化的主要病因是病毒性肝炎(B型和C型)或长期饮酒。大多数患者(60%)同时出现贫血、白细胞减少和血小板减少。骨髓评估显示,118例患者中有117例(99%)骨髓正常、无特异性或有反应性改变。1例患者被诊断为骨髓增生异常综合征。我们的研究结果表明,肝硬化患者外周血细胞减少很少与原发性骨髓病变相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37bf/10342445/3cf287005e8d/jcm-12-04373-g001.jpg

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