The difference between this mean and the mean platelet count in control subjects was not statistically significant (p = 0. 8618). patients with hepatocellular carcinoma (HCC) had a higher platelet count than control subjects (p < 0. 0001), and cirrhotic patients (p < 0. 0001). == Conclusions == Abnormalities of platelet count occur in HBV-related liver disease. Patients with liver cirrhosis tend to have lower platelet count while patients with HCC tend to have higher counts. Thrombocytosis may be a paraneoplastic manifestation of HCC. Keywords: Platelet, Hepatitis B virus, Liver disease, Paraneoplastic syndrome == Introduction == Platelets Rabbit Polyclonal to ADORA1 are the smallest cellular components of human blood, ranging in size from 2 – 4 microns. They are cytoplasmic fragments of the megakaryocyte. Platelets adhere to the site of injury and aggregate with one another, a process known as primary haemostasis. Platelet disorders can be quantitative or qualitative. Quantitative defects are abnormalities in platelet number, whereas qualitative defects are abnormalities in platelet function. Changes in platelet count accompany the progression of various forms of liver disease including those caused by Hepatitis B virus (HBV) [1]. This explains the use of platelet count as an indirect marker in some of the noninvasive assessments of hepatic fibrosis [2]. Thrombocytopaenia is a common feature of chronic liver disease and has been reported in 49-64% of cirrhotic patient [3]. Conversely, an increased platelet count has been demonstrated in several malignancies, and may be an adverse prognostic indicator in that cancers [4-11]. Hepatocellular carcinoma (HCC) happens to be a malignant disease that is HBV-related. Approximately 350 million people worldwide have chronic HBV infection [12, 13] and most of them live in South-East Asia and Sub-Saharan Africa [14]. The natural course of HBV chronic infection is variable, ranging from an inactive SB-277011 dihydrochloride HBsAg carrier state to a more or less progressive chronic hepatitis, potentially evolving to cirrhosis and HCC [15-17]. Determination of platelet count is a relatively simple laboratory procedure. Close monitoring of platelet count may be a useful tool in the follow-up of patients with chronic HBV infection especially in situations where more complex tests and liver biopsy are not readily available. This study was undertaken to determine if there are quantitative platelet abnormalities in Nigerian patients at various stages of liver disease related to HBV, including HCC which represents the end of the disease spectrum. == Materials and Methods == This case-control, prospective and cross sectional study was carried out at the gastroenterology unit of the department of medicine, University of Nigeria Teaching Hospital (UNTH) Ituku/Ozalla between January 2007 and June 2009. Consecutive patients with clinical features of chronic liver disease who tested positive for HBsAg constituted the cases. Asymptomatic individuals referred to the unit after testing positive for HBsAg during screening for blood donation or routine medical examination were also included as cases. The study was approved by the UNTH research ethics committee and informed consent was obtained from all the participants. Each participant was first evaluated with detailed history and complete physical examination with emphasis on the hepatobiliary system. The presence of ascites was specifically documented. Hepatic encephalopathy was graded using the classification adopted at the 11th world congresses of gastroenterology in Vienna [18]. Exclusion criteria: 1, Clinical evidence of infection; 2, Bleeding; 3, Haemolytic disorders; 3, Sickle cell disease; 4, Bone marrow failure; 5, Myeloproliferative disorders. Hepatitis B surface antigen (HBsAg) was tested for in venous blood using an enzyme-linked immunosorbent assay (ELISA) kit that uses polystyrene microwell strips precoated with monoclonal antibodies specific for HBsAg. Those who tested positive were further evaluated with the following routine laboratory tests for the assessment of patients with chronic liver disease: serum bilirubin, liver enzymes (transaminases and alkaline SB-277011 dihydrochloride phosphatase), serum protein (total and albumin), prothrombin time, full blood count including platelet count, urinalysis, abdominal ultrasonography, and where feasible CT scan, HBV DNA and liver biopsy. Platelet count was carried out within 6 hours of sample collection using an automated haematology analyzer (Sysmex XT2000i) manufactured by Sysmex corporation JAPAN. The control group consisted of patients referred for upper gastrointestinal SB-277011 dihydrochloride endoscopy for dyspepsia who did not have alarm symptoms [19], had no clinical evidence of infection or haemorrhage, negative for HBsAg and had no haematological disease. Platelet count was the only additional laboratory test done on the suitable control subjects. All platelet counts were expressed as 109/L and for the purpose of this study the normal range was 150 400 109/L. Based on the clinical features and results of laboratory tests, the patients.