Lymphocyte subsets in alcoholic liver disease

Table 1 Aetiology and clinical presentation of Budd-Chiari syndrome patients at baseline

	All patients	Subgroups
		Medical therapy only	TIPS
	(n = 21)	(n = 7)	(n = 14)
Male/female	6/15	3/4	3/11
Age (yr) at first contact, median (range)	40 (17-66)	41 (17-64)	38 (20-66)
Aetiology, n (%)
Thrombophilia1	7 (33)	2	5
Protein C deficiency	1 (5)	0	1
Protein S deficiency	1 (5)	1	0
Factor V leiden mutation	1 (5)	1	0
Hyperhomocysteinemia	2 (10)	0	2
Paroxysmal nocturnal haemoglobinuria	2 (10)	0	2
Myeloproliferative disorder	4 (19)	2	2
Polycythemia vera	4 (19)	2	2
Other	4 (19)	4	0
Diabetic ketoacidosis	3 (14)	3	0
Angio leiomyosarcoma in caval vena	1 (5)	1	0
Unknown2	7 (33)	0	7
More than one predisposing risk factors	1 (5)3	13	0
Clinical presentation, n (%)
Ascites	15 (71)	3	12
Abdominal pain	14 (67)	6	8
Hepatomegaly	11 (52)	4	7
Jaundice	1 (5)	0	1
Hepatic encephalopathy	1 (5)	0	1
Variceal bleeding	0	0	0

¹13 patients were screened for thrombophilic disorders;

²6 of 7 with unknown risk factors were screened for thrombophilic disorders with negative result;

³This patient suffered from polycythemia vera and had a Factor V Leiden mutation. TIPS: Transjugular intrahepatic portosystemic shunt.

Table 2 Histological findings on liver biopsy n (%)

Fibrosis
Absent	8 (14.3)
Periportal or perisinusoidal	4 (7.1)
Periportal and perisinusoidal	7 (12.5)
Bridging fibrosis	15 (26.8)
Cirrhosis	22 (39.3)
Steatosis
Absent	14 (25)
Mild (< 25%)	33 (58.9)
Moderate (25%-50%)	7 (12.5)
Severe (> 50%)	2 (3.6)
Necroinflammatory activity
Absent	21 (37.5)
Mild	19 (33.9)
Moderate	11 (19.6)
Severe	5 (8.9)
Iron liver stores (Scheuer's Scale on Perls's stain)
Absent	32 (57.1)
Grade 1	11 (19.6)
Grade 2	9 (16.1)
Grade 3	3 (5.4)
Grade 4	1 (1.8)

Table 3 Clinical and laboratory comparison between alcoholic liver disease cases with active alcoholism vs controls with no cirrhosis

	Patients (n = 26)	Controls (n = 27)	P value
Age (yr)	44.4 ± 14.4	47.4 ± 14.4
Men (%)	88.5	14.8	<0.0001
WBC (× 109/L)	6.9 ± 1.8	6.1 ± 1.4	NS
Neutrophils (× 109/L)	4.3 ± 1.5	3.4 ± 1.2	0.011
RBC (× 1012/L)	4.1 ± 0.7	4.5 ± 0.4	NS
Hemoglobin (g/L)	14.0 ± 4.0	13.9 ± 1.2	NS
MCV (fL)	99.9 ± 5.9	90.8 ± 4.0	<0.0001
Platelets (× 109/L)	204.7 ± 84.6	231.0 ± 36.0	NS
INR	1.1 ± 0.2	1.0 ± 0.1	NS
Creatinin (mg/dL	0.9 ± 0.2	0.8 ± 0.1	NS
Albumin (g/dL)	4.0 ± 0.5	3.9 ± 0.6	NS
Albumin/globulin ratio	1.4 ± 0.3	1.4 ± 0.3	NS
Alkaline phosphatase (UI/dL)	102.3 ± 74.1	68.3 ± 14.0	NS
GGT (UI/dL)	297.8 ± 33.1	37.9 ± 33.1	<0.0001
ALT (UI/dL)	55.8 ± 41.6	29.4 ± 15.3	<0.0001
AST (UI/dL)	72.2 ± 52.8	25.1 ± 7.9	<0.0001
Total bilirubin (mg/dL)	1.1 ± 0.6	0.7 ± 0.3	0.027
CRP (mg/dL)	1.1 ± 2.0	0.7 ± 0.7	NS
Lymphocyte Subsets
Lymphocytes (× 109/L)	1.8 ± 0.3	2.1 ± 0.5	0.018
CD3+ lymphocytes (/mm3)	1164.7 ± 376.6	1523.0 ± 364.6	0.001
CD4+ lymphocytes (/mm3)	759.8 ± 265.0	992.4 ± 274.7	0.003
CD8+ lymphocytes (/mm3)	330.9 ± 156.3	478.9 ± 164.6	0.002
CD4+/CD8+ ratio	2.5 ± 1.1	2.3 ± 0.9	NS
CD19+ lymphocytes (/mm3)	107.8 ± 64.2	264.6 ± 88.0	<0.0001
NK lymphocytes (/mm3)	180.2 ± 169.0	178.7 ± 210.0	NS

WBC: White blood cell; RBC: Right blood cell; MCV: Mean cell volume; INR: International normalized ratio; GGT: γ-glutamyl transpeptidase; ALT: Alanine aminotransferase; AST: Aspartate transaminase; CRP: C-reactive protein; NK: Natural killer; NS: Not significant.

Table 4 Clinical and laboratory comparison between alcoholic liver disease cases with cirrhosis but no active alcoholism and controls

	Patients (n== = 11)	Controls (n = 27)	P value
Age (yr)	56.8 ± 9.0	47.4 ± 14.4	0.03
Men (%)	100	14.8	<0.0001
MELD score	10.5 ± 4.6	-
WBC (× 109/L)	5.4 ± 2.5	6.1 ± 1.4	NS
Neutrophils (× 109/L)	3.4 ± 2.0	3.4 ± 1.2	NS
RBC (× 1012/L)	4.5 ± 0.4	4.5 ± 0.4	0.005
Hemoglobin (g/L)	12.9 ± 2.1	13.9 ± 1.2	NS
MCV (fL)	97.0 ± 6.0	90.8 ± 4.0	0.001
Platelets (× 109/L)	103.5 ± 39.4	231.0 ± 36.0	<0.0001
INR	1.4 ± 0.3	1.0 ± 0.1	<0.0001
Creatinin (mg/dL)	0.9 ± 0.3	0.8 ± 0.1	NS
Albumin (g/dL)	3.4 ± 0.7	3.9 ± 0.6	0.003
Albumin/globulin ratio	0.9 ± 0.3	1.4 ± 0.3	<0.0001
Alkaline phosphatase (UI/dL)	124.9 ± 32.6	68.3 ± 14.0	NS
GGT (UI/dL)	84.2 ± 55.5	37.9 ± 33.1	0.005
ALT (UI/dL)	32.6 ± 7.6	29.4 ± 15.3	NS
AST (UI/dL)	46.9 ± 10.9	25.1 ± 7.9	<0.0001
Total bilirubin (mg/dL)	2.2 ± 2.0	0.7 ± 0.3	<0.0001
CRP (mg/dL)	1.1 ± 1.5	0.7 ± 0.7	NS
Lymphocyte Subsets
Lymphocytes (×109/L)	1.3 ± 0.6	2.1 ± 0.5	<0.0001
CD3+ lymphocytes (/mm3)	954.5 ± 547.4	1523.0 ± 364.6	0.003
CD4+ lymphocytes (/mm3)	745.2 ± 389.0	992.4 ± 274.7	0.032
CD8+ lymphocytes (/mm3)	233.9 ± 120.0	478.9 ± 164.6	<0.0001
CD4+/CD8+ ratio	3.5 ± 1.3	2.3 ± 0.9	0.01
CD19+ lymphocytes (/mm3)	150.8 ± 108.4	264.6 ± 88.0	0.001
NK lymphocytes (/mm3)	99.5 ± 54.5	178.7 ± 210.0	NS

MELD: Model for end-stage liver disease; WBC: White blood cell; RBC: Right blood cell; MCV: Mean cell volume; INR: International normalized ratio; GGT: γ-glutamyl transpeptidase; ALT: Alanine aminotransferase; AST: Aspartate transaminase; CRP: C-reactive protein; NK: Natural killer; NS: Not significant.