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Cirrhosis of the Liver Community
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leukopenia and cirrhosis

My husband has cirrhosis for 20 years, been treated 2 times, failed..now he is on teraphy 4 months-epclusa and his alt ast is ok for now..but now he got leukopenia and he already has low platelats...I am arfaid why is this happening, please if someone has idea..thanks
2 Responses
683231 tn?1467326617
Hi do you mean he had hepatitis c for 20 and later because of having hep c was diagnosed with cirrhosis?

That would be my story I was infected with hep c with a liver that was getting worse and finally after  being infected for 30 years I was diagnosed with cirrhosis.  At 37 years I was treated with sovaldi and Olysio but relapsed. I was treated again with harvoni and ribavirin for 24 weeks and cured. Boy now 4 years later I do still have cirrhosis.

leukopenia Is a frequent second illness some with hep c will develop.

I also have low platelets at about 100 from cirrhosis

Let me know what questions you have
3 Comments
Thank you Flyinn, we spoke sometime ago and you have told me your story..and it is very similar with mine. My husband started treatment 4 months ago with eclupsa and I hope    he will beat hep c this time, but now he has leukopenia becide cirrhosis and trombocitopenia, varices and liver pain..so I am questioning if he cure hep c, will leukopenia gone, or can be cured when he stops taking medicines for hep. And how dangerous is leukopenia for him in this moment? And how do you feel Flyinn, do you feel better now, when you beat hep and did you grow stronger now? Pozdrav!
The only way to know what will happen after cure is to be cured and find out what waits ahead.

I never really felt bad the only physical symptom I am aware of is done lower leg edema which is a minor annoyance. I never developed any secondary hep c illnesses I only had the common felling of being more tired than one should which is hard to define with no frame of reference whether it is hep c or simple getting older.

I have had some other mindicatuons of cirrhosis and portal hypertension but those are only through testing like upper endoscopies which indicated I had esophageal varicies that needed banding and a low platelet count but if I was not being followed I would be entirely unaware of these conditions.

Basically I guess I am fortunate even though I was diagnosed with cirrhosis 11 years ago in Jan 2008 I’ve never had any symptoms beyond the edema. I’ve never had what is called extrahepatic (beyond the liver) illnesses that some experience with hepatitis C

As far as your question “how dangerous is leukopenia for him in this moment”

That would be best answered by his hepatologist if it is any more of a concern because of his cirrhosis than it would be otherwise.

Leukopenia is a low white blood cell count that has multiple causes. You may want to look up leukopenia on google and go to trusted sites like the Mayo Clinic or  WebMd for general information about his associated conditions like leukopenia. Med Help doesn’t want us to attach links here.

But as far as how this impacts his health his medical team is best equipped to answer that question.

“Definition
By Mayo Clinic Staff
A low white blood cell count (leukopenia) is a decrease in disease-fighting cells (leukocytes) in your blood. Leukopenia is almost always related to a decrease in a certain type of white blood cell (neutrophil).

The definition of low white blood cell count varies from one medical practice to another. In general, for adults a count lower than 4,000 white blood cells per microliter of blood is considered a low white blood cell count. For children, that threshold varies with age.

Some people who are otherwise healthy have white cell counts that are lower than what's usually considered normal, but which are normal for them.

Causes
By Mayo Clinic Staff
White blood cells are manufactured in bone marrow — the spongy tissue inside some of your larger bones. A low white blood cell count usually is caused by:

Viral infections that temporarily disrupt the work of bone marrow
Certain disorders present at birth (congenital) that involve diminished bone marrow function
Cancer or other diseases that damage bone marrow
Autoimmune disorders that destroy white blood cells or bone marrow cells
Severe infections that use up white blood cells faster than they can be produced
Medications, such as antibiotics, that destroy white blood cells
Sarcoidosis (collections of inflammatory cells in the body)
Specific causes of a low white blood cell count include:

Aplastic anemia
Chemotherapy
HIV/AIDS
Hypersplenism (an abnormality of the spleen causing blood cell destruction)
Kostmann's syndrome (a congenital disorder involving low production of neutrophils)
Leukemia
Lupus
Malnutrition and vitamin deficiencies
Myelodysplastic syndromes
Myelokathexis (a congenital disorder involving failure of neutrophils to enter the bloodstream)
Radiation therapy
Rheumatoid arthritis and other autoimmune disorders
Tuberculosis (and other infectious diseases)

Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.

When to see a doctor
By Mayo Clinic Staff
A low white blood cell count is usually found when your doctor orders tests for a condition you're already experiencing. It's rarely an unexpected finding or simply discovered by chance.

Talk to your doctor about what your test results mean. A low white blood cell count, along with results from other tests, might already indicate the cause of your illness. Or your doctor may suggest other tests to further check your condition.

Because a chronic very low white blood cell count makes you vulnerable to infections, ask your doctor about precautions to avoid catching contagious diseases. Always wash your hands regularly and thoroughly. You might also be advised to wear a face mask and avoid anyone with a cold or other illness.”

683231 tn?1467326617
Thrombocytopenia is a low platelet count it is a common symptom of cirrhosis meaning portal hypertension is occurring. This happens because the liver is so scarred it is difficult for blood to flow through and causes increasing portal vein pressure.
Portal hypertension can cause esophageal varicies. Has he had an upper endoscopy to check for varicies?

Improving platelet counts may happen post cure which would be a good sign of physical improvements of the structure of the liver a reduction of scarring. My pre treatment platelets were about 80 to 90 range and after treatment rose to about 120 but still below normal of 150. They really haven changed since I was cured 3.5 years ago. I asked my hepatologist about having a Fibroscan this spring to see if there have been any signs of reduction of cirrhosis 4 years after I was cured.

They say there’s about a 50% chance of improvement in liver disease for those cured of hepatitis C who have cirrhosis. But so far for me I have had little indication of any changes in my liver disease.

What you do get by being cured is hep C is no longer harming your liver. So if you have no other things going on harming your liver like fatty liver or alcohol your liver won’t get any worse. Whether the liver gets any better depends on how much damage has already occurred before you were cured.

But we should not get any worse and also our odds of getting liver cancer are also greatly reduced. Our liver cancer risk is still high so we will still need blood testing and abdominal ultrasounds every 6 months along with an annual visit to your hepatologist at least that is the protocol my doctor is following he may need more or less frequent testing per his doctor.

We will likely need to be followed for the rest of our lives to make sure if we do develop HCC it can be caught early or if we begin to decompensate.

Best of luck to you both
2 Comments
Thanks a lot to Flyinn for a detailed answer ... so much to me this communication means I always feel better after it ! Best wishes for you!
Good luck
Wishing you a happy holiday season
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