Submitted: 16 Nov 2019
Accepted: 01 Dec 2019
First published online: 01 Dec 2019
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Int J Basic Sci Med. 2019;4(3):86-95.
doi: 10.15171/ijbsm.2019.17
  Abstract View: 12
  PDF Download: 15

Review article

A Review on Clinical, Pathophysiological, and Diagnostic Hematological Features in Children With Liver Cirrhosis 

Iraj Shahramian 1, Kaveh Tabrizian 2, Mojtaba Delaramnasab 3, Ali Khosravi Bonjar 3, Seyed Mohsen Dehghani 4, Omolbanin Sargazi-Aval 3, Ali Bazi 1,3 *

1 Pediatric Digestive and Hepatic Diseases Research Center, Zabol University of Medical Sciences, Zabol, Iran
2 Department of Pharmacology, Zabol University of Medical Sciences, Zabol, Iran
3 Faculty of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran
4 Shiraz University of Medical Sciences, Shiraz, Iran


Appropriate diagnostic and therapeutic measures for liver cirrhosis is critical, particularly in children. In the present review, a comprehensive approach was provided toward hematological parameters in pediatric liver cirrhosis. The literature search included MeSH terms "liver cirrhosis" and "hepatic cirrhosis" and databases such as PubMed, Web of Science, Scopus, and Google Scholar were searched up until December 2017. Hematologic changes in the liver cirrhosis mainly encompassed anemia and coagulopathies. In addition, bleeding diathesis was considered as the most clinical complication in these patients. In addition to reduced coagulation factors, hyperfibrinolysis is a common feature in childhood cirrhosis and may be an important contributor to the risk of bleeding. Based on the results, children with liver cirrhosis also demonstrated a procoagulant state at laboratory and clinical levels. This may be partly due to a reduction in coagulation inhibitors such as anti-thrombin, C1 inhibitor, and α1-antitrypsin in children with cirrhosis. The portal vein thrombosis and portal hypertension are considered as the most clinical presentations of the hypercoagulable state. Further, children with liver cirrhosis complicated with portal hypertension usually show leukopenia, anemia, and thrombocytopenia due to hypersplenism. Although the etiology of childhood and adult cirrhosis may be different, their hematological compilations and clinicopathological features are somehow similar.
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