Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Mar 26;13(1):55.
doi: 10.1186/1471-230X-13-55.

White cell count and platelet count associate with histological alcoholic hepatitis in jaundiced harmful drinkers

Timothy Hardy  1 , Christopher Wells, Stuart Kendrick, Mark Hudson, Christopher P Day, Alastair D Burt, Steven Masson, Stephen F Stewart
Affiliations

White cell count and platelet count associate with histological alcoholic hepatitis in jaundiced harmful drinkers

Timothy Hardy et al. BMC Gastroenterol. .

Abstract

Background: Patients with suspected alcoholic hepatitis and a Discriminant Function ≥32 underwent liver biopsy to confirm the diagnosis. Of these (n = 58), 43 had histological features of alcoholic hepatitis and 15 (25%) did not.We aimed to determine the laboratory features that differentiated those patients with a histological diagnosis of alcoholic hepatitis from those without, and assess potential clinical utility.

Methods: Laboratory investigations at presentation for each of the histologically confirmed cases of alcoholic hepatitis (n = 43) were compared to those without (n = 15) to determine whether there were differences between the two groups. Univariate analysis was by Mann Whitney U Test and Multivariate analysis was by a stepwise approach.

Results: White cell count (16.2 ± 10.5 v 6.9 ± 3.5 (× 109/L); p = 0.0001) and platelet count (178 ± 81 v 98.4 ± 43 (× 109/L); p = 0.0005) were higher in the patients with histological features of alcoholic hepatitis than in those without. The area under the ROC curve for AH diagnosis was estimated to be 0.83 (0.73, 0.94) and 0.81 (0.69, 0.93) for white cell count and platelet count respectively.

Conclusions: Clinicians cannot accurately differentiate patients with or without alcoholic hepatitis without liver biopsy. This is critically important when deciding on specific therapies such as corticosteroids or when interpreting data from future trials in which biopsy is not mandated. In situations where liver biopsy is unsuitable or unavailable the white cell and platelet counts can be used to determine the likelihood of histological alcoholic hepatitis and guide treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
White cell count for diagnosis of AH. The area under the ROC curve is shown for the performance of the White Cell Count for discriminating AH from no AH diagnosis.
Figure 2
Figure 2
Platelet count for diagnosis of AH. The area under the ROC curve is shown for the performance of the Platelet Count for discriminating AH from no AH diagnosis.
Figure 3
Figure 3
Prediction of alcoholic hepatitis by white cell count and platelet count.
See this image and copyright information in PMC

References

    1. MacSween RN, Burt AD. Histologic spectrum of alcoholic liver disease. Semin Liver Dis. 1986;6:221–232. doi: 10.1055/s-2008-1040605. - DOI - PubMed
    1. Lucey MR, Mathurin P, Morgan TR. Alcoholic hepatitis. New Engl J Med. 2009;360:2758–2769. doi: 10.1056/NEJMra0805786. - DOI - PubMed
    1. MacSween RN. Alcoholic liver disease: morphological manifestations. Review by an international group. Lancet. 1981;1:707–711. - PubMed
    1. Ishak KG, Zimmerman HJ, Ray MB. Alcoholic liver disease: pathologic, pathogenetic and clinical aspects. Alcohol Clin Exp Res. 1991;15:45–66. doi: 10.1111/j.1530-0277.1991.tb00518.x. - DOI - PubMed
    1. Chedid A, Mendenhall CL, Gartside P. Prognostic factors in alcoholic liver disease. VA cooperative study group. Am J Gastroenterology. 1991;86:210–216. - PubMed

MeSH terms