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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Mild Cirrhosis From Alcohol. Last Blood Tests In Normal Range Except Platelets Stable At 90-100 Due To Enlarged Spleen. Concerning?

I have mild cirrhosis (compensated) from alcohol. I haven't drank since being diagnosed. My last 3 blood test show my ast drop from 23,to 19 to 18 within the standard range. Alt from 21 to 19 to 18. All blood work is within normal range except platelets which are stable at 90-100.
Should I be concerned with ast and alt getting clap to low range? My low platelets are due to enlarged spleen. Will my spleen ever reduce in size ?
Fri, 30 Aug 2013
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Psychiatrist 's  Response
Hi,
Thanks for writing in to us.

Splenomegaly is a common complication of cirrhosis.

Many cirrhotics have platelet counts in the 60,000s. It is not something to worry about. And it doesn't need to be treated. You have plenty of platelets to properly clot your blood.

Blood flows from the spleen...through the portal vein...then through the liver.
Scar tissue in the liver (cirrhosis) can interfere with that blood flow, causing pressure to build up in the portal vein (portal hypertension), and the spleen to enlarge (splenomegaly).

As the spleen enlarges, it traps platelets. (The amount of platelets in the bloodstream is reduced because the spleen is busy trapping them).
So usually people with cirrhosis end up having a problem with portal hypertension and an enlarged spleen, and a reduced platelet count in the bloodstream.

As time goes by, the liver may try to repair itself by growing new cells. If there is a lot of scar tissue already present the new cells grow between scar tissue (and result in abnormal nodules). The nodules and scar tissue further interfere with blood flow through the liver. So over time people with advanced cirrhosis can end up having a problem with more and more abnormal nodules and scar tissue forming which interferes even more with blood flow through the liver which makes the spleen continue to enlarge and the platelet count continue to drop.

The splenomegaly is usually not reversible. Please go for regular medical follow up.

Hope this helps
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Pathologist and Microbiologist Dr. Vandana Khare's  Response
Hi!
Most important thing that helps in an alcoholic cirrhosis is completely stopping the alcohol consumption.I appreciate you for completely stopping alcohol consumption.
your liver enzymes are showing improvement.Please dont be concerned about lower range because only rising levels indicate deterioration.
your platelet counts are low but stable at 90-100 which is very good sign.
platelets are low due to enlarged spleen and also due to toxic effects of alcohol on bone marrow,so once you have withdrawn from alcohol they will not fall further.splenomegaly however generally is not reversible.
hope this helps!take care!
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Mild Cirrhosis From Alcohol. Last Blood Tests In Normal Range Except Platelets Stable At 90-100 Due To Enlarged Spleen. Concerning?

Hi, Thanks for writing in to us. Splenomegaly is a common complication of cirrhosis. Many cirrhotics have platelet counts in the 60,000s. It is not something to worry about. And it doesn t need to be treated. You have plenty of platelets to properly clot your blood. Blood flows from the spleen...through the portal vein...then through the liver. Scar tissue in the liver (cirrhosis) can interfere with that blood flow, causing pressure to build up in the portal vein (portal hypertension), and the spleen to enlarge (splenomegaly). As the spleen enlarges, it traps platelets. (The amount of platelets in the bloodstream is reduced because the spleen is busy trapping them). So usually people with cirrhosis end up having a problem with portal hypertension and an enlarged spleen, and a reduced platelet count in the bloodstream. As time goes by, the liver may try to repair itself by growing new cells. If there is a lot of scar tissue already present the new cells grow between scar tissue (and result in abnormal nodules). The nodules and scar tissue further interfere with blood flow through the liver. So over time people with advanced cirrhosis can end up having a problem with more and more abnormal nodules and scar tissue forming which interferes even more with blood flow through the liver which makes the spleen continue to enlarge and the platelet count continue to drop. The splenomegaly is usually not reversible. Please go for regular medical follow up. Hope this helps