Thrombocytopenia a Presenting Feature Of Hepatitis C

Abstract

Background: Hepatitis C is now a very common disease in our setup. A majority of patients suffering from this illness present with thrombocytopenia while being investigated for any other medical or surgical illness. Objective: To determine the frequency of association of thrombocytopenia to hepatitis C in newly diagnosed cases. To identify the risk factors for acquiring hepatitis C. Study design and duration of study: It is a Descriptive study conducted at the Department of Hematology (Pathology), Benazir Bhutto Hospital, Rawalpindi from May 2009 to June 2010. Materials and methods: Hundred consecutive patients who were diagnosed for the first time to be suffering from Hepatitis C in the Pathology Department were included in the study. A detailed history was taken to identify any risk factors for the disease causation of Hepatitis C. A peripheral blood sample was taken and complete blood picture analysis was performed to notify the presence of thrombocytopenia. Results: Out of all the 100 patients who were diagnosed for the first time, 25% (n=25) had thrombocytopenia (Platelet count <150 x 103/ul) as a presenting feature. Out of those 25 patients, 13 were females and 12 were males. 8 patients out of these had platelet count < 100 x 103/ul. The most common risk factor in 30% patients (n=30) was frequent management from local General Practitioner, followed by patients with significant history of surgical or invasive procedures in 27% (n=27) and history of dental procedures in 23% patients (n=23). The next in sequence are 17% of those having history of delivery by midwives and history of previous blood transfusion in 10% patients. In order of frequency the other risk factors are; patients with family history of Hepatitis C (10%), patients having multiple sex partners (5%) and finally intra venous drug abusers (2%). However none of the patients who presented to the department had history of dialysis or organ transplant. There was an overlap of risk factors amongst the patients. Conclusion: There is a high frequency of presentation of thrombocytopenia in patients with hepatitis C, causing a considerable morbidity, as diagnosis is delayed and the patients are mismanaged due to lack of awareness and different beliefs regarding the diagnosis and management of this common disease.