Hematologic system damage is common and related to severity in patients with acute hepatitis E

Abstract

Abstract Background: Extrahepatic manifestations of hepatitis E have been extensively reported, yet there is a lack of comprehensive systematic studies on this aspect. This article is to report hematologic systemdamage caused by hepatitis E. Methods: A retrospective study enrolled 170 patients with acute hepatitis E. The study analyzed the proportion of patients with decreased white blood cell, hemoglobin, and platelet levels in their blood routine, along with their potential clinical significance. 49 patients with HA were also included as controls to compare and analyze the differences in biochemical indicators and hematologic damage. Results: Among the 170 patients with hepatitis E, 47 cases (27.64%) presented with leukopenia, 94 cases (55.29%) exhibited anemia, and 33 cases (19.41%) experienced thrombocytopenia. The findings indicated that hemoglobin and platelets are lower in patients with hepatitis E than in patients with hepatitis A, and anemia is more common in patients with hepatitis E. The anemia group had significantly lower levels of albumin, alanine aminotransferase, and cholinesterase compared to the normal group (p<0.001, p=0.005, p<0.001). Additionally, total bilirubin and alkaline phosphatase were significantly higher in the anemia group than in the normal group (p=0.031, p=0.003). Moreover, the anemia group showed a higher likelihood of experiencing spontaneous bacterial peritonitis (p=0.025). In comparison to the normal platelet group, the thrombocytopenia group exhibited significantly lower levels of albumin, cholinesterase, and prothrombin activity (p=0.036, p=0.015, p<0.001). Patients with decreased platelet have the higher incidence of death, spontaneous bacterial peritonitis, upper gastrointestinal bleeding and hepatorenal syndrome (p<0.001, p<0.001, p=0.027, p=0.014). Conclusion: Hepatitis E patients with hematologic system damage are common. Patients with hepatitis Ehave lower levels of hemoglobin and platelets compared to patients with hepatitis A. The presence of anemia and low platelets in patients with hepatitis Eindicates a more severe condition.