Haematological Abnormalities in Decompensated Chronic Liver Disease

PRALAYAKAVERI DWARAKA — 2025-06-28

Abstract

Introduction:
Decompensated chronic liver disease (DCLD) represents an advanced stage of hepatic dysfunction, often accompanied by significant hematological abnormalities. These include anemia, thrombocytopenia, and coagulation disorders, which not only reflect disease severity but also influence the risk of complications such as gastrointestinal (GI) bleeding. This study aimed to assess the prevalence, patterns, and clinical significance of hematological abnormalities in DCLD patients.

Materials and Methods:

This study was conducted in the Department of General Medicine. Fifty adult patients diagnosed with DCLD were enrolled based on predefined inclusion and exclusion criteria. Relevant clinical history, physical examination, and laboratory investigations including complete blood count, peripheral smear, liver function tests, serum iron profile, serum folate, prothrombin time (PT), and international normalized ratio (INR) were recorded and analyzed.

Results:
Among 50 DCLD patients, 42 (84%) were males. Alcoholic cirrhosis (66%) was the most common etiology. Anemia was observed in 94% of patients, with normocytic morphology being the most frequent (57.4%). Thrombocytopenia was present in 72% of cases, and prolonged PT and elevated INR were noted in 68% and 74% of patients, respectively. A statistically significant association was found between thrombocytopenia and GI bleeding (p = 0.047), and also between GI bleeding and elevated PT (p = 0.009) and INR (p = 0.012).

Conclusion:
Hematological abnormalities are highly prevalent in DCLD and show a strong association with bleeding complications. Early identification and appropriate management of these derangements are crucial to improving patient outcomes.

A Case Report: Forced Alkaline Diuresis in a Case of 2, 4 D Dimethyl-Amine Herbicide Poisoning

Sagar Gupta — 2025-05-19

To study the use of 2, 4 D is increasing because of resistance emerging
in Paraquat and Glycophosphate for weed control, hence accidental
or suicidal intoxication incidences are rising. Action of this is dose
dependent with detrimental effects on cell membrane of Acetyl - CoA
metabolism and oxidative phosphorylation.
It is fatal if not treated timely, having no specific antidote involving
CNS, CVS, RS, Hepatoblliary, muscle and endocrine systems. Usually,
it is very common with intoxication of organophospate compounds in
India, similar to alcohol, sedative drugs, aromatic compounds which is
suspected when patient comes to emergency room. So, Identification
of correct compound for timely management can be lifesaving.
Prolonged Coma, Metabolic complications, Skeletal muscle complication
are some of the complications of 2 4 D. Treatment with forced alkaline
diuresis is life saving measure in resource limited rural area where
hemodialysis is not available.

How to cite this article:
Gupta S, Deshmukh R, Deshpande S, Patki S,
Akotkar S, Suradkar P. A Case Report : Forced
Alkaline Diuresis in a Case of 2, 4 D Dimethyl
Amine Herbicide poisoning. J Adv Res Med 2025;
12(1): 1-3.

DOI: https://doi.org/10.24321/2349.7181.202501

Journal of Advanced Research in Medicine (E-ISSN: 2349-7181 & P-ISSN: 2394-7047)

Haematological Abnormalities in Decompensated Chronic Liver Disease

A Case Report: Forced Alkaline Diuresis in a Case of 2, 4 D Dimethyl-Amine Herbicide Poisoning