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ORIGINAL ARTICLE
Year : 2018  |  Volume : 31  |  Issue : 2  |  Page : 588-593

Correlation of thrombocytopenia with grading of esophageal varices in chronic liver disease patients


1 Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Tropical Medicine, Menouf Fever Hospital, Menoufia, Egypt

Correspondence Address:
Ahmed H El-Daly
Department of Tropical Medicine, Menouf Fever Hospital, Menoufia 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.239725

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Objective The aim of this study was to determine the correlation of thrombocytopenia with esophageal variceal grading in chronic liver disease patients. Background Esophageal varices (EVs) are a serious consequence of portal hypertension in patients with chronic liver disease. Several studies have evaluated possible noninvasive predictors for the presence and size of varices, including platelet count. Materials and methods This study included 210 patients who presented with chronic liver disease in Menouf Fever Hospital. The diagnosis was based on history, clinical, laboratory, and imaging data. They were divided into two groups: group I and group II. Group I included 140 patients with EVs and was subdivided into group IA, which included 60 patients with grade I, group IB, which included 40 patients with grade II, and group IC, which included 40 patients with grade III, and group II included 70 patients without EVs. Correlation of thrombocytopenia with the grading of EVs was assessed using Spearman's correlation. Results Platelet count was significantly lower in patients with EV grades I, II, and III (mean ± SD; 100.5 ± 19.8, 65.2 ± 13.0, and 60.3 ± 14.1 × 103/mm3, respectively) than in those without EVs (152.1 ± 17.1 × 103/mm3). Moreover, it was significantly lower in patients with grades II and III (large EVs) (65.2 ± 13.0 and 60.3 ± 14.1 × 103/mm3, respectively) than in patients with grade I (small EVs) (100.5 ± 19.8 × 103/mm3) (P < 0.001). The cutoff value of platelet count as a predictor for the presence of EVs was less than or equal to 130 × 103/mm3, with a sensitivity of 95% and specificity of 95%. Moreover, the cutoff value as a predictor for the presence of large EVs was less than or equal to 80 × 103/mm3, with a sensitivity of 91.2% and a specificity of 86.7%. There was a significant negative correlation between platelet count and grading of EVs (r=−0.756; P < 0.001). Conclusion Thrombocytopenia is a good noninvasive predictor for the presence and size of EVs in chronic liver disease patients. There was a significant negative correlation between platelet count and grading of EVs.


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