Von Willebrand Factor and VITRO Score as Predictors for Variceal Bleeding in Egyptian Patients with Liver Cirrhosis, MOHAMED B. HASHEM, IMAN HAMZA, AYA AMGED, SHIRIHAN MAHGOUB and AHMED HASHEM
Abstract
Background: Variceal bleeding isa majorcause of death in patients with cirrhosis. Von Willebrand factor (vWF) is a pro-tein released by endothelial cells (ECs), reflects EC activation. Levels of vWF had been discovered to be higher in people with liver cirrhosis; however, there is a scarcity of information about its role in prediction of portal hypertensive bleeding. Blood test measuring Von Willebrand factor-Ag level (vWF-Ag) com-bined with platelet count allowed the development of a novel prediction score, the von Willebrand factor/thrombocyte ratio (the VITRO score). Aim of Study: To assess the relationship between the von Willebrand factor and the VITRO score with variceal bleeding in cirrhotic patients. Patients and Methods: 42 cirrhotic patients and 19 healthy controls were included in the study. The patients were catego-rized into two groups: 21 cirrhotic patients with recent variceal bleeding and 21 cirrhotic patients without variceal bleeding. All patients underwent Laboratory tests including vWF/Ag and upper endoscopy. vWF level andVITRO scorewere compared-between both groups and 19 normal controls. Results: Patients with variceal bleeding had significantly higher level of vWF (12ng/ml) compared to patients without bleeding (9.2ng/ml) and normal controls (9.6ng/ml). Patients with variceal bleeding also had higher VITRO score (0.174), compared to patients without bleeding (0.058) and normal con-trols (0.037), the difference was statistically significant. Conclusion: We suggest that the vWF and VITRO score can be used as noninvasive biomarkers for the prediction of variceal bleeding in patients with liver cirrhosis with high sen-sitivity and specificity.