Non-endoscopic predictors of esophageal varices in children with chronic liver disease and their utility in resource-constrained countries

Alam, Rafiqul; Karim, Asm Bazlul; Rukunuzzaman,; Yasmin, Afsana; Hossen, Kamal; Benzamin, Md.

doi:10.1007/s12664-019-00960-9

Cited by 4 publications

(9 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings were consistent with few other studies. 11,12,18,20,21 It was hypothesized Child-Pugh classification would be a good marker of the presence of varices as it takes into account the results of liver function tests (prothrombin time and albumin). Use of two subjective criteria (ascites and staging of hepatic encephalopathy) may be the cause of lack of correlation, which may under or overscore some patients.…”

Section: Resultsmentioning

confidence: 99%

Association between severity of chronic liver disease with grading of oesophageal varices in children

Alam

Karim

Rukunuzzaman

et al. 2022

Bangabandhu Sheikh Mujib Medical University Journal

Self Cite

View full text Add to dashboard Cite

Chronic liver disease is a uncommon manifestation in the children and many of them presents with oesophageal varices. The aim of this study was to observe the association between severity of chronic liver diseases determined by Child- Pugh score with grading of oesophageal varices. 62 cases (male, 34) were included in the present study. Mean age of the study population was 9.5±3.3 years. Male to female ratio was 1.2:1. Wilson’s disease was the most common etiology of chronic liver disease (64.5%). Of the 62 children, 30.7% had Child class A, 16.1% had Child class B and the remaining 53.2% had Child class C cirrhosis. Oesophageal varices were found in 43 (69.3%) children. On univariate ananlysis low platelet count and splenomegaly were found to be associated with the presence of esophageal varices. Splenomegaly was found as independent predictor for presence of varices on multivariate analysis (OR; 15.51, 95% CI, 3.7-63.5). Furthermore, splenomegaly was also independent risk factor for large esophageal varices. No association was found between Child-Pugh classification (child A, B, C) with grading of oesophageal varices (Grade - I, II, III, IV). Our study showed no positive association between Child-Pugh classifications with grading of esophageal varices. Splenomegaly predicts the presence of oesophageal varices as well as the presence of large esophageal varices. BSMMU J 2022; 15(1): 29-34

show abstract

Section: Resultsmentioning

confidence: 99%

Association between severity of chronic liver disease with grading of oesophageal varices in children

Alam

Karim

Rukunuzzaman

et al. 2022

Bangabandhu Sheikh Mujib Medical University Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…The current therapeutic options include beta-blockers (mainly propranolol) and endoscopic methods, particularly elastic ligation of EVs" [11]. Esophageal varices were found in 71.4% of Bangladeshi children with CLD [12]. In Canada, Gana et al [13] found that 69% of studied children had EVs, while in Brazil, Fuguendes et al [14] found that 60% had EVs on their first upper GI endoscopy.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Chronic Liver Disease (CLD) Based on Esophageal Varices in Children

Roy,

Mondal,

Rukunuzzaman

2023

AJPR

View full text Add to dashboard Cite

Background: Chronic Liver Disease (CLD) is a complex and often debilitating condition that affects individuals of all ages, including children. Within pediatric CLD, one critical aspect that demands careful evaluation is the presence and severity of esophageal varices. If left untreated, these enlarged, fragile blood vessels in the esophagus can lead to life-threatening bleeding. The assessment of esophageal varices plays a pivotal role in managing and prognosis of children with CLD. Aim of the Study: The study aims to measure laboratory parameters and calculate serum liver fibrosis scores in CLD children. Methods: This retrospective study analyzed 24 pediatric patients diagnosed with esophageal varices in Chronic Liver Disease (CLD) at the Department of Pediatric Gastroenterology & Nutrition, BSMMU, Dhaka, Bangladesh, over two years from April 2019 to October 2021. Ethical standards were adhered to with informed consent and ethical committee approval. Results: According to the diagnoses, 50% of the patients were identified as having Wilson's disease. Notably, 16.7% of the patients presented with Grade 4 esophageal varices. In terms of laboratory parameters, the median hemoglobin level was 10.2 gm/dl, the total leukocyte count was 6300/mm3, the platelet count had a median of 90000/µL, the bilirubin level had a median of 2.7 gm/dl, ALT had a median of 57 U/L, AST had a median of 134.5 U/L, GGT had a median of 132 U/L, INR had a median of 1.6, albumin had a median of 25 gm/dl, and cholesterol had a median of 105 mg/dl. Lastly, the median liver stiffness was recorded as 13.1 kPa, with an interquartile range (IQR) spanning from 10.3 to 21. Conclusion: This study highlights the importance of early detection and management of esophageal varices in children with CLD, as they are crucial prognostic indicators for underlying liver conditions. By integrating these clinical tools and parameters, healthcare providers can make informed decisions regarding the management and treatment of children with CLD. Early identification of esophageal varices and a comprehensive assessment of the liver's functional status are essential in improving the overall care and outcomes for pediatric patients with chronic liver disease, ensuring timely intervention and support to enhance their quality of life.

show abstract

“…Platelet, ALT, AST, and related indexes Low platelet count (PC; <150,000/mm 3 ) was present in more patients with EVs (72.73%) than in patients without EVs (41.18%) (P < 0.05) [25]. PC, therefore, can be a predictor of the presence of EVs [26,27]. However, PC was not independently associated with EVs in the study of Rahmani P et al [28 & ].…”

Section: Methods Based On Serum Biomarkersmentioning

confidence: 99%

“…Among patients with CLDs, splenomegaly occurs at a higher frequency in patients with EVs (100%) than in patients without EVs (70.6%) (P < 0.05) [25]. Splenomegaly was an independent predictor for the presence of EVs [26]. In univariate and multivariable analysis, spleen length was associated with the presence of EVs [32].…”

Section: The Diagnosis Of Small Varicesmentioning

confidence: 99%

Small varices in chronic liver diseases

Zhu

Cheng

Chen

et al. 2022

Current Opinion in Gastroenterology

View full text Add to dashboard Cite

Purpose of reviewGastroesophageal varices are common complications of chronic liver diseases (CLDs) and portal hypertension. Small varices have the risk of progressing to larger varices, causing bleeding or even death. Thus, early detection and appropriate management of small varices are necessary. The purpose of this review is to summarize the advance in the recent 5years about diagnosing and managing the small varices in CLDs. Recent findingsThe diagnosing methods of small varices in recent studies include improved endoscopic examinations, such as capsule endoscopy, and many noninvasive methods, including blood tests, ultrasound, computed tomography and magnetic resonance. For the management of small varices, though it is controversial, prevention using nonselective beta-blockers is still an essential part.

show abstract

Non-endoscopic predictors of esophageal varices in children with chronic liver disease and their utility in resource-constrained countries

Cited by 4 publications

References 28 publications

Association between severity of chronic liver disease with grading of oesophageal varices in children

Association between severity of chronic liver disease with grading of oesophageal varices in children

Assessment of Chronic Liver Disease (CLD) Based on Esophageal Varices in Children

Small varices in chronic liver diseases

Contact Info

Product

Resources

About