Results of a comparative statistical clinical study on the hemostasis coagulation in HBs Ag positive and HBs Ag negative viral hepatitis. Experimental investigations on medullar megacaryocytopoiesis in thrombocytopenia complicating viral hepatitis (Italian)

A statistical survey of blood coagulation disorders in 185 selected patients suffering from viral hepatitis showed that alterations of blood coagulation were generally more evident in HBs Ag positive than in HBs Ag negative patients, but only differences observed initially in prothrombin activity and in the 'r' and the 'r + k' thromboelastographic parameters proved to be statistically significant. A significantly more pronounced, though transient trend to thrombocytopenia was observed at the 3rd week after admission to hospital in HBs Ag positive patients. Concomitant studies on bone marrow from 11 patients with complicating thrombocytopenia performed on the basis of several cytological parameters of megakaryocytopoiesis (absolute and differential frequency, maturation curve, cell size and mitotic index) allowed differentiation between a hypo and a hyper regenerative (direct or indirect lesion of megakaryocytes) pattern. In some of the cases with the hyper regenerative pattern antiplatelet antibodies were irregularly observed. Interestingly, in some of these cases the platelet aggregation test of Penttinen et al. disclosed the presence of immunocomplexes, the latter containing HBs Ag in sera from HBs Ag positive patients.