Plasma Von Willebrand Factor Antigen As a predictor of Oesophageal Varices In Patients with Liver Cirrhosis

Abstract

Bleeding oesophageal varices (OVs) due to portal hypertension (PHT) are one of the major complications with high mortality in liver cirrhosis. So, early detection and management are mandatory. Objectives: to evaluate serum Von Willebrand factor (vWF) levels as a predictor for esophageal varices and prognosis in patients with liver cirrhosis. Patients and Methods: This is a cross sectional study which was carried out on 50 patients with liver cirrhosis representing different Child-Pugh classes were recruited from El Mataria hospital internal medicine department and from Ain Shams University Hospital, Department of Internal Medicine from February(2019) to June (2019). addition to 25 apparently healthy subjects saving as a healthy control were included in this study. All patients were submitted to full history taking, clinical examination, laboratory investigations and abdominal ultrasonography. The severity of liver disease was estimated by Child-Pugh score. All patients were underwent upper gastrointestinal endoscopy and vWF assay. Results: VWF-Ag was significantly higher in the patients who have liver cirrhosis than the healthy control (p-values of 0.000). VWF-Ag level was significantly higher in patients with OVs than those without varices (p value 0.007). while there was no statistically significance when comparing different grades of varices (p value 0.203). Receiver operating characteristics (ROC) curve analysis of vWF revealed that, vWF at cutoff value of >21; the sensitivity for detection of esophageal varices was 82.0%, specificity 100.0%, positive predictive value (PPV) was 100.0%, negative predictive value (NPV) was 73.0%. conclusion: VWF-Ag could be used as a non invasive laboratory independent predictor for the detection of OVs.