Non-Invasive Parameters of Oesophageal Varices Diagnosis: Which Sensitive and Applicable; A Pilot Study

Hassan, Elham Ahmed; El-Rehim, Abeer Sharaf El-Din Abd; Sayed, Zain El-Abdeen Ahmed; Kholef, Emad Farah Mohamed; Hareedy, Mostafa Abdullah Mohammed; EL-aal, Refaat Fathy Abd

doi:10.4172/2167-0889.1000182

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…In our study, there was a male preponderance, with 82/97 (84.5%) being males and 15 (15.4%) being females, with a male-to-female ratio of 5.6:1. These results regarding gender were consistent with those reported by Hassan et al [11] and Montasser et al [7] with a male-to-female ratio of 5.6:1 and 3:1, respectively. The reason for male preponderance might be related to the higher percentage of alcohol consumption and high-risk behavior for contracting hepatitis B and C.…”

Section: Discussionsupporting

confidence: 93%

Serum Ammonia Levels as a Non-invasive Predictor of the Presence and Severity of Oesophageal Varices in Chronic Liver Disease Patients

Kumar¹,

Kansal²,

Chaudhary³

et al. 2023

Cureus

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BackgroundPortal hypertension leads to the formation of portosystemic collateral veins, of which esophageal varices (EV) are the most severe complications and have the greatest clinical impact. The possibility of identifying cirrhotic patients with varices by non-invasive tests is appealing, as they can lead to reduced healthcare costs and can be done in resource-limited settings. In this study, we investigated ammonia as a potential non-invasive predictor of EV. MethodsThis was a single-center cross-sectional observational study that was done at a tertiary health care hospital in north India. It included 97 chronic liver disease patients irrespective of etiology after excluding patients with portal vein thrombosis and hepatocellular carcinoma to participate in endoscopic screening for the presence of EV and correlate it with various non-invasive markers like serum ammonia levels, thrombocytopenia and aspartate aminotransferase to platelet ratio index (APRI ). On the basis of endoscopy, enrolled patients were divided into two groups, i.e., group A consisting of large varices (grade III and grade IV) and group B consisting of patients with low-grade varices and no varices (grade II, grade I, and no varices). ResultsThis study included 97 patients, out of which 81 patients have varices on endoscopy, and mean serum ammonia levels were found to be significantly higher in cases with varices (135 ±69.70 ) vs. those without varices (94±43) (p value=0.026). Further, on comparing serum ammonia values between patients with large varices (Grade III/IV) (Group A) with a mean value of 176 ± 83 vs. Grade I/II/No varices (Group B) with a mean value of 107±47, which were significantly higher in Group A patients (<0.001). In our study, we also found a correlation between blood urea level as a non-invasive predictor of varices, but no statistically significant relation was found between thrombocytopenia and APRI. ConclusionThis study found that serum ammonia can be used as a useful marker for the prediction of EV and can also be used to determine the severity of varices. Apart from ammonia, serum urea levels can also prove to be a good non-invasive marker for the prediction of varices although further multicentric studies are warranted to reach this conclusion.

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Section: Discussionsupporting

confidence: 93%

Serum Ammonia Levels as a Non-invasive Predictor of the Presence and Severity of Oesophageal Varices in Chronic Liver Disease Patients

Kumar¹,

Kansal²,

Chaudhary³

et al. 2023

Cureus

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“…Several investigations have found that splenomegaly can predict LEV in cirrhotic individuals (15,16,17) . This is consistent with Hassan et al (18) , who concluded that ultrasound examination revealed that the PVD of patients with OV was substantially greater than that of patients without OV.…”

Section: Discussionsupporting

confidence: 92%

Fibroscan in Grading and Prediction of the Risk of Bleeding of Gastro-Esophageal Varices in HCV related Cirrhotic Patients

Omar,

Salama,

Saad

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: By measuring liver stiffness (LS) with transient elastography (TE), portal hypertension and the presence of oesophageal varices (OV) were investigated. In HCV-related cirrhotic individuals, fibroscan is capable of predicting the presence of esophageal varices. And probable categorization based on degree of hepatic rigidity.Objective: This research aimed to use fibroscan and a prospective grade based on degree of liver stiffness as a means of diagnosing esophageal varices earlier in people with cirrhosis caused by HCV. Methods: Ultrasonography was used to evaluate 250 Egyptian HCV-related cirrhotic patients, aged >18, with a BMI of < 35 and no history of ascites, GIT hemorrhage, HCC, abdominal collaterals, portal or splenic vein thrombosis. They classified the varices as group I (no varices), group II (little varices), and group III (big varices). Results: All Groups were matched for age and BMI. In group III, Platelet count was lower & MELD was higher significantly than in groups I &

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“…In accordance to our result Jamil Z et al [25]; Gunda DW et al [26] with cutoff point: 15.2 cm; sensitivity 65.9% and specificity 65.2%. Hassan EA et al [27] also found a significantly increase in SLD in patients with EV in comparison to patients without. They showed that a SLD ≥ 13.1 cm had 100% sensitivity and 65% specificity for the prediction of EV.…”

Section: Fig 4 Roc Curve Of Immature Platelet Fraction In Predictinmentioning

confidence: 87%

Immature Platelet Fraction as a Non-Invasive Marker for Esophageal Varices

Soliman

Abd‐Elsalam

Al-Bendary

et al. 2021

JAMMR

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Background: All cirrhotic patients should be screened for oesophageal varices (OV) at the time of diagnosis. The development of a non-invasive method for the detection of OV is a vital issue in subjects with cirrhosis to decrease the need for invasive endoscopic procedures that can be costly. This work aimed to evaluate immature platelet fraction (IPF) as a non-invasive marker and predictor of OV. Methods: This cross-sectional study was carried out on 80 cirrhotic patients with esophageal varices diagnosed by upper endoscopy. They were divided into Group (1): 40 patients with cirrhosis with esophageal varices and Group (2): 40 patients with cirrhosis and without esophageal varices. All patients were subjected to the complete history taking, physical examination, routine laboratory investigations (Complete blood count, IPF, C-reactive protein, Liver and kidney function tests, Bone marrow aspiration for some cases, Ascetic sample analysis when applicable), Pelvic-Abdominal ultrasonography, Child Pugh score assessment, Upper GIT endoscopy. Results: There was a significant difference between the studied groups regarding IPF (p<0.001). At cutoff >12 IPF had (AUC= 0.993) with sensitivity of 97.5% and specificity of 97.5% for detection of esophageal varices. There was a significant negative correlation between IPF and platelets count (p- value < 0.001). There was a significant positive correlation between IPF and Child Pugh score (p- value <0.001). There was a highly significant positive correlation between IPF and CRP (p value <0.001). There was significant difference between the two groups as regards splenic longitudinal diameter (p<0.001). As regards platelet count, there was a significant difference between the two groups (p<0.001). It was significantly lower in Group 1. Conclusions: IPF is elevated in cirrhotic patients with naive esophageal varices than in cirrhotic patients without varices. IPF could be used as a noninvasive, easy to measure method for detection of the presence of esophageal varices at a cutoff level of >12.

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Non-Invasive Parameters of Oesophageal Varices Diagnosis: Which Sensitive and Applicable; A Pilot Study

Abstract: Background: Oesophageal varices (OV) have the greatest clinical impact. Upper endoscopy is the gold standard for OV diagnosis, despite its own limitations. Non-invasive detection of OV promises to decrease the necessity of endoscopic screening.

Cited by 8 publications

References 22 publications

Serum Ammonia Levels as a Non-invasive Predictor of the Presence and Severity of Oesophageal Varices in Chronic Liver Disease Patients

Serum Ammonia Levels as a Non-invasive Predictor of the Presence and Severity of Oesophageal Varices in Chronic Liver Disease Patients

Fibroscan in Grading and Prediction of the Risk of Bleeding of Gastro-Esophageal Varices in HCV related Cirrhotic Patients

Immature Platelet Fraction as a Non-Invasive Marker for Esophageal Varices

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