A laboratory and thrombokinetic study of HCV-associated thrombocytopenia: A direct role of HCV in bone marrow exhaustion?

Objective. In order to investigate HCV associated thrombocytopenia, 6 patients suffering from this disease, in the absence of splenomegaly and other common causes of peripheral platelet destruction, underwent laboratory and scintigraphic tests. Results. Thrombokinetic studies revealed a significant, nearly linear, delayed splenic accumulation with normal or low-normal values for the average platelet life span, low-normal recovery, and depressed platelet production. Megakaryopoiesis was normal or slightly increased. HCV infection of the megakaryocytes was found in two patients. Autoantibodies and liver disease were also investigated. Conclusions. A role of immunological mechanisms in HCV associated thrombocytopenia appears to be ruled out. The authors conclude that tests for HCV infection should be included in the evaluation of thrombocytopenia in adults and a possible direct involvement of HCV cannot be excluded.