Predictors of Bleeding from Esophageal Varices: The Role of Factor VII and von Willebrand Factor (vWF)

Ghweil, Ali A.; Arafa, Usama Ahmed; Khodeary, Ashraf; Salem, Ahmed N.

doi:10.4236/ojgas.2014.44023

Cited by 7 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ferlitsch et al reported that VWF-Ag correlated with HVPG (r = 0.69; P < 0.0001) and predicted clinically significant portal hypertension independently of Child Pugh score and higher VWF-Ag levels were associated with varices [8]. Ghweil et al reported that VWF-Ag level was higher in patients with bleeding varices than those without bleeding and its value was independent predictor of esophageal variceal bleeding [16].…”

Section: Discussionmentioning

confidence: 99%

Reliability of Plasma Von Willebrand Factor Antigen in Prediction of Esophageal Varices in Patients with Liver Cirrhosis

Mahmoud¹,

Ghweil²,

Bazeed³

et al. 2015

OJGas

View full text Add to dashboard Cite

Background: Bleeding esophageal varices (OVs) due to portal hypertension are one of the major complications with high mortality in liver cirrhosis. So, early detection and management are mandatory. Aim: To evaluate the role of Von Willebrand factor (VWF) in predicting the presence of OVs. Patients and Methods: 62 patients with liver cirrhosis representing different Child-Pugh classes were included. The diagnosis of liver cirrhosis was based on the combination of clinical, laboratory and US examinations. All included patients underwent the following investigations: complete blood count, liver function tests (ALT, AST, serum bilirubin, albumin and total protein, prothrombin time (PT) and concentration (PC), INR and serum alkaline phosphatase), serum creatinine, Von Willebrand factor antigen (VWF-Ag) measurement and abdominal US. Upper endoscopic evaluation was done to detect presence or absence of varices (esophageal or gastric) and/or PHG. Results: 38 males and 24 females with their mean age (46 ± 12 years old) were included. Plasma Von Willebrand factor-Ag level was significantly higher in patients with OVs than those without varices (P value = 0.000). Also, its level was significantly higher in patients with higher grade of OVs, G3 than those with G1 or G2 (P value = 0.000). Patients with large OVs including those with G2 and G3 showed significantly higher values of VWF than those with small OVs (NO and G1) (P value = 0.000). VWF was independent predictor for detecting the presence of OVs with good sensitivity (90), specificity (77.3) and accuracy (85.5) at a cutoff value of 1.74 U/ml. Also it was an independent predictor for detecting the presence of large OVs with good sensitivity (91.2), specificity (85.7) and accuracy (88.7) at a cutoff value of 2.16 U/ml. Conclusion: VWF-Ag could be used as a non invasive laboratory independent predictor for the detection of OVs.

show abstract

Section: Discussionmentioning

confidence: 99%

Reliability of Plasma Von Willebrand Factor Antigen in Prediction of Esophageal Varices in Patients with Liver Cirrhosis

Mahmoud¹,

Ghweil²,

Bazeed³

et al. 2015

OJGas

View full text Add to dashboard Cite

show abstract

“…Ghweil et al [7] and Yilmaz et al [18] reported that plasma vWF-Ag level increases in adult cirrhotic patients and this is accompanied by higher stages of cirrhosis according to CPS. Wu et al [19] and Ferlitsch et al [20] reported that vWF is a noninvasive predictor of PH and EVs in patients with cirrhosis, at cut-off values of 141 IU/ml and 241 IU/ml, respectively, and increased levels of vWF in liver tissues may induce elevated plasma vWF levels, supporting our results which reported a high vWF-Ag level of 368.2 (±199.8) IU/ml in group I in comparison with its mean of 160.4 (±144.4) IU/ml in group II, with a highly statistically significant difference between the two groups (p < 0.0001) (Table 3 and Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Ghweil et al . [ 7 ] and Yilmaz et al . [ 18 ] reported that plasma vWF-Ag level increases in adult cirrhotic patients and this is accompanied by higher stages of cirrhosis according to CPS.…”

Section: Discussionmentioning

confidence: 99%

“…Von Willebrand factor is a large, multimeric and highly glycosylated protein which plays a crucial role in both primary hemostasis, by mediating platelet aggregation and adhesion to the sub-endothelium at sites of vascular lesions, as well as in blood coagulation by acting as the blood carrier of factor VIII [ 6 ]. It is released by activated endothelial cells, so it is considered as an indicator of endothelial activation and development of thrombotic vascular obliteration and the possible mechanism of PH [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Von Willebrand factor and esophageal varices in children with chronic liver diseases

El‐Guindi¹,

Adawy²,

Osheba³

et al. 2021

ceh

View full text Add to dashboard Cite

Aim of the study:To evaluate the role of plasma level of von Willebrand factor antigen (vWF-Ag) as a possible predictor for the presence of esophageal varices (EVs) in children with chronic liver diseases (CLDs). Material and methods: All patients underwent upper esophagogastroduodenoscopy (EGD) and were categorized as group I (had EVs) and group II (had no EVs). The following patient data were determined: Child-Pugh score (CPS), plasma vWF-Ag, vWF-Ag/thrombocyte ratio (VITRO) score, aspartate transaminase (AST) to platelet ratio index (APRI) score, AST/alanine transaminase (ALT), platelet count/spleen diameter, grading of EVs (small, medium and large) and categorizing the stage of liver fibrosis. Results: The analysis included 50 patients with CLD; 30 (60%) were female. The commonest etiological diagnoses were autoimmune hepatitis (AIH) (20%) and extra-hepatic biliary atresia (EHBA) (12%). 26% of cases were categorized as undiagnosed CLD. The CPS showed CPS-A 34%, CPS-B 44% and CPS-C 22%. The vWF-Ag was found at a high level of 243.52 ±195.97, with a highly statistically significant difference in discriminating the EVs with 74% accuracy at a cut-off value of 108.99 IU/ml, p < 0.0001. Also, ROC analysis was performed for discriminating large esophageal varices with 84% accuracy at a cut-off value of 475.85 mg%. The VITRO score at a cut-off value of 1.72 could detect EVs with 70% sensitivity, 86.7% specificity, and 80% accuracy. Conclusions: High vWF-Ag is a valuable prognostic tool for estimating the presence of EVs, and higher vWF-Ag is associated with increased grade of EVs.

show abstract

Gastroesophageal variceal hemorrhage in patients with chronic liver diseases attending university of Gondar Specialized comprehensive hospital in Ethiopia: Institutional based cross-sectional study

Baye¹,

Abay²,

Tesfaye³

et al. 2023

Heliyon

View full text Add to dashboard Cite

Predictors of Bleeding from Esophageal Varices: The Role of Factor VII and von Willebrand Factor (vWF)

Cited by 7 publications

References 12 publications

Reliability of Plasma Von Willebrand Factor Antigen in Prediction of Esophageal Varices in Patients with Liver Cirrhosis

Reliability of Plasma Von Willebrand Factor Antigen in Prediction of Esophageal Varices in Patients with Liver Cirrhosis

Von Willebrand factor and esophageal varices in children with chronic liver diseases

Gastroesophageal variceal hemorrhage in patients with chronic liver diseases attending university of Gondar Specialized comprehensive hospital in Ethiopia: Institutional based cross-sectional study

Contact Info

Product

Resources

About