Urotensin II plasma levels in children with presinusoidal portal hypertension

Abstract

P resinusoidal portal hypertension (Portal vein thrombosis and congenital hepatic fibrosis) are common causes of portal hypertension in children that is responsible for the lethal complications as: gastro-esophageal varices and massive gastrointestinal bleeding. UII is potent vasoconstrictor, which is greater than that of endothelin-1. UII shows to be related to many diseases having vasoconsticion role in their pathogenesis. This study is designed to evaluate the serum level of Urotensin II in children with presinusoidal portal hypertension and to correlate its level to the severity of the disease. This study was conducted on twenty-five patients; all of them had clinical, Doppler ultrasound and endoscopic evidence of presinusoidal portal hypertension. In addition, fifteen controls. The serum UII was measured in patients and controls and found to be correlated with presence of presinusoidal portal hypertension with mean of 3.65±2.65 (ng/ml) in patients and mean of .91±.92 (ng/ml) in controls UII in serum was found to be correlated positively with number of bleeding attacks, and negatively with serum Albumin. The PHG (portal hypertensive gastropathy) grade was correlated with serum U-II level being more severe with higher UII level. The cutoff point that differentiates between patients with presinusoidal portal hypertension and controls was found to be 1.05 ng/mL with sensitivity of 80% and specificity of 80%. The number of bleeding attacks was found to be more in CHF than in PVT. The PHG grade was more severe in CHF than in PVT, while PVV (portal vein velocity) was higher in CHF than in PVT. UII in serum was found to be higher in CHF than in PVT. We can serum conclude that UII is higher in presence of presinsusoidal portal hypertension being more severe in CHF than in PVT, and so can be used to assess progression of presinusoidal portal hypertension especially grading of PHG.