Characteristics of clinical and anamnestic data and of condition of primary hemostasis in chronic diseases of liver in children

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Abstract


Aim. To perform a comparative analysis of clinical and anamnestic data and of the condition of primary hemostasis in chronic liver diseases in children and to identify additional informative diagnostic criteria that reflect severity of the course of autoimmune hepatitis (AIH) and chronic viral hepatitis C (CVHC) in children.

Materials and Methods. 91 Patients from 3 to 7 years old were examined, of them: 60 children with AIH and 31 children with CVHC. The control group included 15 children of I and II health groups. In all the patients the clinic-anamnestic data and the condition of the primary hemostasis were evaluated. Concentrations of endothelin-1 and homocysteine, activity of Willebrand factor, amount of platelets and their aggregation activity were determined.

Results. AIH is characterized by a more aggressive course as compared to CVHC manifested by clinical signs of a severe liver damage, significant biochemical changes and a high rate of fibrosis within the first two years. In all the children there were found disorders in the primary hemostasis interrelated with the main clinical and laboratory syndromes reflecting the severity of the liver damage. AIH is characterized by a higher concentration of homocysteine (р=0.007) and of the activity of Willebrand factor (р=0.037) in comparison with CVHC.

Conclusions. Signs of a severe liver damage are not characteristic of children with CVHC in the first 10 years of the disease, however, disorders of the primary hemostasis are present characterized by hyperaggregation of platelets and by endothelial dysfunction. AIH in children is characterized by aggressive course and more pronounced deviations of the primary hemostasis in comparison with CVHC. In AIH and CVHC, the pathology of the primary hemostasis is closely related to some clinical-laboratory symptoms that reflect severity of the disease.


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Ekaterina Yu. Konovalova

Privolzhsk Research Medical University

Author for correspondence.
Email: ekaterinapashkina@yandex.ru
ORCID iD: 0000-0003-1059-6293
SPIN-code: 4437-3176
Scopus Author ID: 57200184951
ResearcherId: H-1099-2018

Russian Federation, Nizhny Novgorod

Junior Researcher of the Department «Clinic of Gastroenterology and Metabolic Disorders»

Alla E. Lavrova

Privolzhsk Research Medical University

Email: lavrova26@mail.ru
ORCID iD: 0000-0002-0447-214X
SPIN-code: 1040-2836
Scopus Author ID: 57190812376
ResearcherId: H-5209-2018

Russian Federation, Nizhny Novgorod

МD, PhD, Leading Researcher of the Department «Clinic of Gastroenterology and Metabolic disorders»

Marina V. Presnyakova

Privolzhsk Research Medical University

Email: Presnyakova@list.ru
ORCID iD: 0000-0002-3951-9403
SPIN-code: 2188-3549
ResearcherId: H-4567-2018

Russian Federation, Nizhny Novgorod

PhD in Biological Sciences, Senior Researcher of the Biochemical Laboratory

References

  1. Della Corte C, Mosca A, Vania A, et al. Pediatric liver diseases: current challenges and future perspectives. Expert Review of Gastroenterology & Hepatology. 2016;10(2):255-65. doi: 10.1586/17474 124.2016.1129274
  2. Volynets GV, Potapov AS, Skvortsova TA. Scientific Centre of Children Health, Moscow, Russian Federation Chronic Hepatitis C in Children: Problems and Prospects. Annals of the Russian Academy of Medical Sciences. 2014;(11-12):46-53. (In Russ). doi: 10.15690/vramn.v69i11-12.1182
  3. Enomoto H, Nishiguchi Sh. Similarities and Differences in Autoimmune Hepatitis Epidemiology between East and West: Autoimmune Hepatitis in East Asia, Southeast Asia, and South Asia. Inflammatory Intestinal Diseases. 2017;1(4):150-8. doi:10. 1159/000454879
  4. EASL Clinical Practice Guidelines: Autoimmune hepatitis. Journal of Hepatology. 2015;63(4):971-1004. doi: 10.1016/j.jhep.2015.06.030
  5. Sun LJ, Yu JW, Shi YG, et al. Hepatitis C virus core protein induces dysfunction of liver sinusoidal endothelial cell by down-regulation of silent information regulator 1. Journal of Medical Virology. 2018;90(5):926-35. doi: 10.1002/jmv.25034
  6. Batyrova AS, Bakanov MI, Surkov AN. The modern concepts of hemostasis system under chronic diseases of liver: the publications review. Klini-cheskaya Laboratornaya Diagnostika. 2015;60(8): 40-4. (In Russ).
  7. Kurkina IA, Maevskaya MV, Ivashkin VT. Hypercoagulation and thrombosis in patients with liver cirrhosis. Poliklinika. Gastroenterologiya. 2015;(4-2):20-6. (In Russ).
  8. Boyer TD, Habib Sh. Big spleens and hyper-sp-lenism: fix it or forget it? Liver International. 2015; 35(5):1492-8. doi: 10.1111/liv.12702
  9. Tana MM, Zhao X, Bradshaw A, et al. Factors associated with the platelet count in patients with chronic hepatitis C. Thrombosis Research. 2015; 135(5):823-8. doi: 10.1016/j.thromres.2015.02.010
  10. Massoud OI, Zein NN. The Effect of Transjugular Intrahepatic Portosystemic Shunt on Platelet Counts in Patients With Liver Cirrhosis. Gastroenterology & Hepatology. 2017;13(5):286-91.
  11. Jiang A, Zhang S, Li Z, et al. miR-615-3p promotes the phagocytic capacity of splenic macrophages by targeting ligand-dependent nuclear receptor corepressor in cirrhosis-related portal hypertension. Experimental Biology and Medicine. 2011;236(6): 672-80. doi: 10.1258/ebm.2011.010349
  12. Ito A, Yoshizawa K, Fujimori K, et al. Autoimmune Hepatitis Associated with Immune Thrombocytopenic Purpura. Internal Medicine. 2017;56(2): 143-7. doi: 10.2169/internalmedicine.56.7506
  13. Matsuo R, Nakano Y, Ohkohchi N. Platelet Administration Via the Portal Vein Promotes Liver Regeneration in Rats After 70% Hepatectomy. Annals of Surgery. 2011;253(4):759-63. doi: 10.1097/SLA. 0b013e318211caf8
  14. Kurokawa T, Ohkohchi N. Platelets in liver disease, cancer and regeneration. World Journal of Gastroenterology. 2017;23(18):3228-39. doi: 10.3748/wjg. v23.i18.3228
  15. Wojtala M, Pirola L, Balcerczyk A. Modulation of the vascular endothelium functioning by dietary components, the role of epigenetics. BioFactors. 2017;43(1):5-16. doi: 10.1002/biof.1306
  16. Wereszczynka-Siemiatkowska U, Swidnicka-Sier-giejko AK, Siemiatkowski A, et al. Endothelin 1 and transforming growth factor-β1 correlate with liver function and portal pressure in cirrhotic patients. Cytokine. 2015;76(2):144-51. doi:10.1016/ j.cyto.2015.05.025
  17. Bocca C, Novo E, Miglietta A, et al. Angiogenesis and Fibrogenesis in Chronic Liver Diseases. Cellular and Molecular Gastroenterology and Hepatology. 2015;1(5):477-88. doi: 10.1016/j.jcmgh. 2015.06.011
  18. Hollestelle MJ, Poyck PPC, Hollestelle JM, et al. Extrahepatic factor VIII expression in porcine fulminant hepatic failure. Journal of Thrombosis and Haemostasis. 2005;3(10):2274-80. doi: 10.1111/j.1538 -7836.2005.01543.x
  19. Mieli-Vergani G, Vergani D, Baumann U, et al. Diagnosis and Management of Pediatric Autoimmune Liver Disease: ESPGHAN Hepatology Com-mittee Position Statement. Journal of Pediatric Gastroenterology and Nutrition. 2018;66(2):345-60. doi: 10.1097/MPG.0000000000001801
  20. Nielsen NS, Jespersen S, Gaardbo JC, et al. Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection. International Journal of Molecular Sciences. 2017;18(5):1016. doi: 10.3390/ijms18051016

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Copyright (c) 2020 Konovalova E.Y., Lavrova A.E., Presnyakova M.V.

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