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In the study by Abdulrasak et al. (2025), cytopenias, which are reductions in blood cell counts, were identified as a significant but often overlooked complication in autoimmune liver diseases, including primary biliary cholangitis (PBC). The causes of cytopenias in PBC are primarily attributed to hypersplenism, a condition where the spleen is overactive, often due to portal hypertension (high blood pressure in the portal vein). This can lead to an enlarged spleen that sequesters or traps blood cells, causing their counts to drop.
The researchers emphasize the importance of a thorough diagnostic process that includes clinical history, blood tests, and potentially bone marrow evaluation. Treatment focuses on the root cause, such as using beta-blockers or performing a splenectomy (surgical removal of the spleen) for hypersplenism. The study highlights the need for careful management of these conditions, especially in the context of preparing patients for liver transplants.
