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Noninvasive markers for esophageal varices in children with cirrhosis

Parisa Rahmani1, Fatemeh Farahmand1, Ghobad Heidari2

  • 1Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Clinical and Experimental Pediatrics
|July 29, 2020
PubMed

Insights

Noninvasive markers like platelet count and APRI can help identify children with high-risk esophageal varices (EV), potentially reducing the need for invasive endoscopy. This aids in diagnosing EV in pediatric liver cirrhosis patients.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Diagnostic Imaging

Background:

  • Esophageal varices (EV) diagnosis relies on invasive procedures like esophagogastroduodenoscopy (EGD).
  • There's a need for noninvasive, cost-effective methods to diagnose EV in children with liver cirrhosis.

Purpose of the Study:

  • To identify noninvasive markers for diagnosing esophageal varices in pediatric liver cirrhosis patients.

Main Methods:

  • Cross-sectional study of 98 children with liver cirrhosis.
  • Evaluation of spleen size, platelet count, liver function tests, and risk scores before endoscopy.
  • Endoscopic assessment for EV presence, severity, and red signs.

Main Results:

  • Esophageal varices were found in 43.9% of subjects.
  • Univariate analysis showed significant differences in spleen size, platelet count, INR, APRI, platelet count to spleen size ratio, and risk score between patients with and without EV.
  • Logistic regression revealed no independent association between these parameters and EV presence.

Conclusions:

  • Platelet count, risk score, platelet count to spleen size ratio, and APRI show potential for identifying high-risk EV patients.
  • These noninvasive markers may decrease the reliance on invasive EGD for EV diagnosis in children.
Abstract

Keywords:
Gastroesophageal varicesGastrointestinal endoscopyLiver cirrhosisPediatricsPortal hypertension

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