Platelets Count As A Predictor For Portal Hypertension in Patients With Ascites


Background: Serum Ascetic Albumin Gradient is a good biochemical marker and a better discriminator of portal hypertension. Patients with gradients of >1.1 g/dL have portal hypertension, while those with gradients of <1.1 g/dL do not, with accuracy rate 97% and sensitivity of 100%. Thrombocytopenia is a frequent and challenging clinical disorder in patients with portal hypertension. The most sensitive and specific laboratory finding suggestive of cirrhosis in the setting of chronic liver disease is a low platelet count (<150×109/L), which occurs as a result of portal hypertension and hypersplenism. Aim of Study:To predict the presence of portal hypertension in patient with ascites by measuring the platelets count.Patients and Methods: Fifty patients with ascites were sent for complete blood picture, serum albumin, echo study, abdominal ultrasound and albumin in ascites fluid along with thorough medical history and examination. we calculate the SAAG for all patients and classified into two groups , the first has SAAG> 1.1 g/dl and considered to have portal hypertension, the second has SAAG <1.1 g/dl. Results: In this study, 50 patients with ascites their ages ranges from (34-60) years ,25 of them had SAAG more than 1.1g/dl , 20 of them had platelet count <150×109/L. while 25 patients with SAAG less than 1.1g/dl, 7 of them had platelet count <150×109/L. this indicate significant correlation between low platelet count and portal hypertension(p value 0.0002)(the measured sensitivity=84%, specificity=76%, P.P.V=77%, N.P.V=82%) . Another significant correlation was seen between splenomegaly detected by U/S and portal hypertension, 25 patient had SAAG more than 1.1g/dl, of them 12 had splenomegaly ( p value 0.00039)(the measured sensitivity=48%, specificity=96%, P.P.V=92%, N.P.V=64%)Conclusion: Thrombocytopenia in patient with ascites may predict portal hypertension.