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Type: Artigo de periódico
Title: Non-invasive Predictors Of Esophageous Varices In Children And Adolescents With Chronic Liver Disease Or Extrahepatic Portal Venous Obstruction
Author: De Alcantara R.V.
Yamada R.M.
De Tommaso A.M.A.
Bellomo-Brandao M.A.
Hessel G.
Abstract: Objective: To identify non-invasive predictors of esophageal varices in children and adolescents with chronic liver disease or extrahepatic portal venous obstruction (EHPVO). Methods: 53 patients younger than 20 years with chronic liver disease or EHPVO and no history of bleeding or prophylactic treatment of esophageal varices (EV) were assessed. They were divided into 2 groups: group I (35 with chronic liver disease) and group II (18 with EHPVO). Their blood count, international normalized ratio (INR), albumin, bilirubin, abdominal ultrasonography and upper endoscopy results were taken. A splenic index was determined by dividing the patients' spleen dimension by its uppermost limit according to their age. The variables were compared to EV presence or not. Univariate (chi-square test, Fischer's exact test and Wilcoxon exact test) and multivariate (logistic regression) analyses were performed. A receiver operating characteristic (ROC) curve was constructed and the area under the ROC curve was calculated. Results: EV were observed in 48.5% of group I patients and in 83.3% of group II patients. Low platelet count (p = 0.0015), splenomegaly (p = 0.0003) and splenic index (p = 0.0007) were statistically significant predictors of EV among group I patients. The multivariate analysis showed low platelet count (odds = 21.7) as an independent predictor of EV in patients with chronic liver disease. Conclusion: Platelet count, splenic index and platelet-splenic index ratio were predictors of EV in children and adolescents with chronic liver disease. There were no EV predictors among group II patients. Copyright © by Sociedade Brasileira de Pediatria.
Rights: aberto
Identifier DOI: 10.2223/JPED.2205
Date Issue: 2012
Appears in Collections:Unicamp - Artigos e Outros Documentos

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