Role of platelet‑associated immunoglobulin G in hypersplenism‑associated thrombocytopenia

Introduction Hypersplenism is characterized by cytopenia, splenomegaly, and increased or normal bone marrow cellularity. Platelet‑associated immunoglobulin G (PAIgG) is a class of platelet autoantibodies bound to the surface glycoprotein of the platelet and is mainly produced by the spleen. Significant higher PAIgG levels were found in patients with thrombocytopenic purpura and cirrhotic hypersplenism. Aim The aim was to assess the antiplatelet immunoglobulin G antibodies level in patients with hypersplenism‑associated thrombocytopenia before and after, first, medical treatment (growth factors and corticosteroids) and second, surgical treatment (splenectomy). Patients and methods This study included 40 patients with hypersplenism and 10 age‑matched and sex‑matched healthy controls. Serum antiplatelet IgG was measured by ELISA technique using Human antiplatelet IgG (anti‑PA IgG) ELISA Kit. Results In both the splenectomized and the medical groups, PAIgG had insignificant decrease during follow‑up in comparison with baseline level (in case of the splenectomized group, 224.50 ± 51.32 vs 206.30 ± 69.82 μg/ml, P = 0.33, and in case of the medical group, 200.81 ± 55.41 vs 186.60 ± 72.29 μg/ml, P = 0.07). Conclusion An immune process may be mediated by PAIgG, and secondary hypersplenism due to portal hypertension is associated with thrombocytopenia in patients with liver cirrhosis. The authors also found that patients with splenomegaly subjected to splenectomy had a significant elevation of platelet counts and insignificant reduction in PAIgG levels.