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Role of Plasma Von Willebrand Factor-Antigen in predicting the presence of Esophageal Varices and occurrence of its bleeding in cirrhotic patients

Article 4Volume 9, Issue 2, June 2019, Page 139-149  

Document Type: Original Article

DOI: 10.21608/AEJI.2019.12190.1020

Authors

Mona Ahmed Abdelmaksoud1Amal A Jouda email 1Talaat Fathy1Ahmad Mokhtar Ahmad Ibrahim2Ahmad Sallam Soliman2Ahmad Baraka2Mohammad N Elkhashab1

1Tropical Medicine Department, Faculty of Medicine, ZagazigUniversity,Egypt.

2Clinical Pathology Department, faculty of Medicine, ZagazigUniversity,Egypt.

Abstract

Background and study aim: Baveno VI consensus recommended the use of non- invasive predictors of EV to avoid unnecessary endoscopies. Von Willbrand factor (VWF) and VITRO score, (VWF/ platelet count), are both correlated to liver cirrhosis and fibrosis. The aim of this study was to evaluate the role of VWF and VITRO score as predictors of esophageal varices and their bleeding.
Patients and Methods: Seventy seven patients were included in this study. They were randomly selected from cirrhotic patients admitted to endoscopy unit for the first time. They were allocated into two groups;group I:patients who have esophageal varices,groupII:patients with no esophageal varices.
Results: VWF Ag and VITRO score were significantly higher in the varices group (group I). VWF Ag level was 169.3±20.2 in group I vs 146.8±35.5 µg/dL in group II p<0.001. VITRO score was 2.2±1.1 in group I vs 1.6±0.7 µg/108 platelet p=0.05. We found that at cut off value of 153% VWF can predict the presence of EV with sensitivity 88.1% and specificity of 61.1% and AUC= 0.66 p=0.04. VITRO score can predict the presence of varices with sensitivity of 69.5% and specificity of 50% at a cut off value 1.5 AUC=0.065 P=0.05.
Conclusion: VWF and VITRO score rise significantly in patients with esophageal varices. Both markers can be reliable in prediction of the presence of EV’s. VWF Ag can be reliable marker in prediction of risky and bleeding varices.

Keywords

VWFVITRO scorenon-invasiveesophageal varicesmarker

Main Subjects

Hepatology