ITP, Serotonin, and cirrhosis

I've been treated for ITP for a dozen years or so, largely with Prednisone, more recently, and successfully, with NPlate. Even before the ITP, my doc told me I had elevated liver enzymes and probably non alcoholic fatty liver disease (NAFLD). In 2013, the ITP-oncologist said, let's try WinRho. It worked, but almost killed me: (Intravascular hemolysis). Judging from the jaundice and lab reports, I think it was a big kick in the liver. The ER discovered severe non-alcoholic hepatitis.

I have often wondered what connections there might be between my ITP and what is now cirrhosis -it seems too unlucky I've acquired them independently). Amidst the furiously complicated biology of ITP and cirrhosis, I think might see a vicious-circle: 1) portal hypertension (high blood-pressure in the vein supplying a damaged liver) can inflate the spleen, and worsen the platelet destruction of ITP. 2. Meanwhile, serotonin which is not only a neurotransmitter but a regulatory hormone involved in wound repair (and lots of other stuff), is made in the gut but mostly carried around the body by platelets. Hmm. Serotonin has been research-studied in mice and found to be importantly related to liver regeneration after partial liver removal. Maybe (my speculation) platelet-transported serotonin helps the a liver-under-stress keep up its regenerative capacity.

So is my speculation a known thing? IS THERE A KNOWN PROPENSITY FOR PEOPLE WITH ITP TO BE MORE VULNERABLE TO LIVER DEGENERATION (NASH-Cirrhosis)?

The liver problems have more than likely caused your ITP. As far as I am aware ITP itself doesn't cause problems within the liver.

I agree with MrsB. Very few ITP patients have problems with their liver. However, liver problems can cause thrombocytopenia.

I can't comment on your question Jim. But, Holy Smokes, I like your idea. Look at the flip side of your question.

Take a look at the two rows in my ITP types/responses table that suggest the liver is the destruction location. They are rows 2a and 2b. What if taking Promacta/Nplate increases counts and then allows the liver to regenerate itself as you describe? That would explain why taking these drugs leads to lower doses and finally remissions given enough time. Liver regeneration.

Thanks for sharing the idea. Is what I describe consistent with your thoughts?