Related Experiment Video

Updated: Sep 27, 2025

Underwater Endoscopic Injection Sclerotherapy for Gastroesophageal Varices
02:14

Underwater Endoscopic Injection Sclerotherapy for Gastroesophageal Varices

Published on: August 1, 2025

525

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

Mohamed Abdel-Salam El-Guindi1, Nermin Mohammed Adawy1, Iman Shaban Osheba2

  • 1Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt.

Clinical and Experimental Hepatology
|April 11, 2022
PubMed

Insights

High plasma levels of von Willebrand factor antigen (vWF-Ag) can predict esophageal varices (EVs) in children with chronic liver disease (CLD). Elevated vWF-Ag levels correlate with the severity of EVs, offering a valuable prognostic tool.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Biomarker Discovery

Background:

  • Chronic liver diseases (CLDs) in children can lead to serious complications such as esophageal varices (EVs).
  • Accurate prediction of EVs is crucial for timely intervention and management in pediatric CLD patients.
  • Non-invasive biomarkers are needed to assess the risk of EVs.

Purpose of the Study:

  • To investigate the utility of plasma von Willebrand factor antigen (vWF-Ag) levels as a predictor for the presence of EVs in children with CLDs.
  • To assess the correlation between vWF-Ag levels and the grade of EVs.

Main Methods:

  • A cohort of 50 children with CLD underwent upper esophagogastroduodenoscopy (EGD) to diagnose EVs.
  • Plasma vWF-Ag levels, Child-Pugh score (CPS), and other relevant clinical and laboratory parameters were analyzed.
  • Receiver operating characteristic (ROC) analysis was used to determine the accuracy of vWF-Ag in predicting EVs.

Main Results:

  • Plasma vWF-Ag demonstrated high accuracy (74%) in discriminating the presence of EVs at a cut-off of 108.99 IU/ml (p < 0.0001).
  • Higher vWF-Ag levels were significantly associated with the presence and increased grade of EVs.
  • The VITRO score also showed good accuracy (80%) in detecting EVs.

Conclusions:

  • Elevated plasma vWF-Ag is a valuable prognostic marker for identifying children with CLD who are at risk of developing EVs.
  • vWF-Ag levels correlate with the severity of esophageal varices, aiding in risk stratification.
  • This finding supports the potential use of vWF-Ag as a non-invasive tool in managing pediatric CLD.
Abstract

Keywords:
chronic liver diseasesesophageal varicesvon Willebrand factors

More Related Videos

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices04:09

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices

Published on: June 13, 2025

403
Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension04:00

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Published on: November 15, 2024

340

Related Concept Videos

Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
413
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
162
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
179
Varicose Veins I: Introduction01:26

Varicose Veins I: Introduction

Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...
31
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
303
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
330