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• W4385188003 abstract "Background: Neutropenia is reduction in the absolute number of neutrophils in blood circulation. Common causes include increased destruction, reduced production, or excessive splenic sequestration. Neutropenia can be mild (Absolute Neutrophil Count (ANC) of 1000-1500/L), moderate (ANC 500-1000/L), or severe (ANC <500/L). Patients with severe neutropenia are presumed to be at risk of life-threatening infections. There is lack of information on neutropenia following hypersplenism and portal hypertension. Methods: We undertook this observational study in patients with ANC <1500/L and liver disease and portal hypertension from January 2017 till April 2019. Results: We identified 15 patients with neutropenia. Mean age 33.13 (range 17-68) years. The average duration of neutropenia was 4.6(range 1-17) years. The mean ANC was 632 (248-1152) cells/L. Mild, moderate and severe neutropenia seen in 1,8, and 6 patients respectively. Mean hemoglobin, total leucocyte count and platelets were 7.96 (4.4-13.1) g/d, 1305 (550-2910) /L and 0.47 (0.15-1.13) /L respectively. Spleen size was 18.2 (9-23) cm. Mean total bilirubin, AST and ALT levels were 1.63 (0.2-4.3) mg/dl, 47.2 (20-157) IU/L and 34.6 (14-59) IU/L respectively. All (except one) had an infection free follow-up with no admission due to infection. Only 1 patient (ANC 446/L) with Wilson disease (WD) was admitted twice, once for candidemia and the other for rickettsial infection; both episodes resolved with standard therapy. Cause of liver disease: EHPVO=7, NCPF=4, Alcoholic Liver disease=2, congenital hepatic fibrosis=1 and WD=1. The WD patient over 4 years of follow up developed 4 episodes of SBP, urinary tract infection and pneumonia, which was ascribed to progression of liver disease. The ANC rose to normal levels (>1500/L) at each infectious occasion. Conclusion: Neutropenia may rarely complicate portal hypertension and hypersplenism, particularly in EHPVO and NCPF. Contrary to perception, neutropenia is not a harbinger of infection or increased mortality/morbidity in portal hypertension." @default.
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• W4385188003 date "2023-01-01" @default.
• W4385188003 modified "2023-09-30" @default.
• W4385188003 title "Severe Neutropenia Associated With Hypersplenism and Portal Hypertension: Does it Predispose to Increased Infection Episodes?" @default.
• W4385188003 doi "https://doi.org/10.1016/j.jceh.2023.07.097" @default.
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