Citation Information :
Vijayakumar S, Ramasamy S, Ibrahim SU. Thrombocytopenia in Alcohol Dependence Syndrome: A Hospital-based Observational Study. Ind J Priv Psychiatry 2025; 19 (1):30-35.
Aim and background: Thrombocytopenia is a condition characterized by a decrease in platelet counts less than 1,50,000/µL. Multiple studies have elicited the effect of alcohol on various blood parameters but its effect on platelets is often overlooked. We intend to estimate the prevalence of thrombocytopenia in alcohol dependence syndrome (ADS), to compare the platelet count at baseline with that of the 7th day of admission, to evaluate the association between platelet count with the severity of ADS, and co-morbidities in patients with ADS.
Materials and methods: This is an observational study conducted in a tertiary care Medical College Hospital. We recruited 64 inpatients qualifying for ADS whose last intake of alcohol was within five days before admission. Severity of alcohol dependence questionnaire (SADQ) and Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale were administered, platelet count along with CBC was assessed during baseline, and only platelet count was assessed on the 7th day of admission. Statistical analysis paired sample t-test, ANOVA, Pearson's correlation were used.
Results: The prevalence of thrombocytopenia at baseline was 18.8% which dropped to 9.4% on day 7 of admission following abstinence from alcohol. At baseline patients with liver disease had significantly lower platelet count than those without liver disease (Mean: 1,93,900/µL vs 2,40,500/µL, p: 0.031) but no statistically significant difference on 7th day (p: 0.8). Baseline platelet count showed negative correlation with age, duration of alcohol use.
Conclusion: The prevalence of thrombocytopenia is high in patients with ADS.
Clinical significance: Abstinence from alcohol can lead to normalization of platelet count even in patients with co-morbid liver disease.
Jinna S, Khandhar PB. Thrombocytopenia 2022; pp. 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
Eichner ER. The hemotologic disorder of alcoholism. Am J Med 1973;54(5):621–630. DOI: 10.1016/0002-9343(73)90120-4.
Peltz S. Severe thrombocytopenia secondary to alcohol use. Postgrad Med 1991;89(6):75–85. DOI: 10.1080/00325481.1991.11700918.
Lindenbaum J, Hargrove RL. Thrombocytopenia in alcoholics. Ann Intern Med 1968;68(3):526–532. DOI: 10.7326/0003-4819-68- 3-526.
Harshe DG, Thadasare H, Karia SB, et al. A study of patterns of platelet counts in alcohol withdrawal. Indian J Psychol Med 2017;39(4): 441–444. DOI: 10.4103/0253-7176.211766.
Silczuk A, Habrat B. Alcohol-induced thrombocytopenia: Current review. Alcohol 2020;86:9–16. DOI: 10.1016/j.alcohol.2020. 02.166.
Nisha S, Amita D, Uma S, et al. Prevalence and characterization of thrombocytopenia in pregnancy in Indian women. Indian J Hematol Blood Transfus 2012;28(2):77–81. DOI: 10.1007/s12288-011-0107-x.
Silczuk A, Habrat B, Starowicz ML. Thrombocytopenia in patients hospitalized for alcohol withdrawal syndrome and its association to clinical complications. Alcohol and Alcoholism 2019;54(5):503–509. DOI: 10.1093/alcalc/agz061.
Berggren U, Fahlke C, Berglund KJ, et al. Thrombocytopenia in early alcohol withdrawal is associated with development of delirium tremens or seizures. Alcohol 2009;44(4):382–386. DOI: 10.1093/alcalc/agp012.
Jandl JH, Aster RH, Forkner CE, et al. Splenic pooling and the pathophysiology of hypersplenism. Trans Am Clin Climatol Assoc 1967;78:9–27. PMID: 5339085.
Pujani M, Chauhan V, Singh K, et al. The effect and correlation of smoking and platelet indices, neutrophil lymphocyte ratio, and platelet lymphocyte ratio. Hematol Transfus Cell Ther 2021;43(4): 424–429. DOI: 10.1016/j.htct.2020.07.006.
Silverstein P. Smoking and wound healing. Am J Med 1992;93 (1A):22S–24S. DOI: 10.1016/0002-9343(92)90623-j.
Latvala J, Parkkila S, Niemela O. Excess alcohol consumption is common in patients with cytopenia: Studies in blood and bone marrow cells. Alcohol Clin Exp Res 2004;28(4):619–624. DOI: 10.1097/01.alc.0000122766.54544.3b.
Sullivan LW, Herbert V. Suppression of hematopoiesis by ethanol. J Clin Invest 1964;43(11):2048–2062. DOI: 10.1172/JCI105079.
Eichner ER, Hillman RS. The evolution of anemia in alcoholic patients. Amer J Med 1971;50(1):218–232. DOI: 10.1016/0002-9343(71)90151-3.
Herbert V, Zalusky R, Davidson CS. Correlation of folate deficiency with alcoholism and associated macrocytosis, anemia and liver disease. Ann Intern Med 1963;58:977–988. DOI: 10.7326/0003-4819-58-6-977.
Sullivan LW, Herbert V. Suppression hematopoiesis by ethanol. J Clin Invest 1964;43(11):2048–2062. DOI: 10.1172/JC1105079.
Post RM, Desforges JF. Thrombocytopenia and alcoholism. Ann Intern Med 1968;68(6):1230–1236. DOI: 10.7326/0003-4819-68-6-1230.
Cooper GW, Dinowitz H, Cooper B. The effects of administration of ethyl alcohol to mice on megakaryocyte and platelet development. Thromb Haemost 1984;52(1):11–14. PMID: 6541816.
Levine RF, Spivak JL, Meagher RC, et al. Effect of ethanol on thrombopoiesis. Br J Haematol 1986;62(2):345–354. DOI: 10.1111/j.1365-2141.1986.tb02938.x.
Smith C, Gasparetto M, Jordan C, et al. The effects of alcohol and alcohol dehydrogenases on disorders of hematopoiesis. Adv Exp Med Biol 2015;815:349–359. DOI: 10.1007/978-3-319-09614-8_20.