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Prevalence and associated factors with esophageal varices in early primary biliary cirrhosis
Author(s) -
Ikeda Fusao,
Okamoto Ryoichi,
Baba Nobuyuki,
Fujioka Shinichi,
Shoji Bon,
Yabushita Kazuhisa,
Ando Masaharu,
Matsumura Shuji,
Kubota Junichi,
Yasunaka Tetsuya,
Miyake Yasuhiro,
Iwasaki Yoshiaki,
Kobashi Haruhiko,
Okada Hiroyuki,
Yamamoto Kazuhide
Publication year - 2012
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2012.07114.x
Subject(s) - medicine , esophageal varices , gastroenterology , varices , odds ratio , primary biliary cirrhosis , cirrhosis , portal hypertension
Background and Aims: Recent routine testing for anti‐mitochondrial antibodies has increased the number of patients with early primary biliary cirrhosis (PBC). The prevalence and clinical significance of esophageal varices in those patients remains obscure. Methods: A systematic cohort analysis of 256 PBC patients was performed to clarify the prevalence, characteristics, and prognosis of the patients with early PBC and esophageal varices. Results: Twenty‐two patients had esophageal varices at the time of diagnosis: 5.5% (12/217) with early disease of histological stage 1 or 2, and 25.6% (10/39) with advanced disease of stage 3 or 4. Immediate treatments were required for two patients with early PBC: one for bleeding varices, and the other for large varices. The overall survival of the patients with early PBC and esophageal varices at diagnosis did not significantly differ from that of patients without esophageal varices ( P = 0.66). High alkaline phosphatase (ALP) ratios (odds ratio = 2.3) and low platelet counts (odds ratio = 0.77) were significantly associated with the presence of esophageal varices in the patients with early PBC. Significant associations of these two factors with the development of esophageal varices during follow‐up were also revealed (odds ratio = 1.4 and 0.88, respectively). The patients with early PBC and high ALP ratios ≥ 1.9 had significantly high risks of developing esophageal varices during follow‐up ( P = 0.022). Conclusions: High ALP ratios and low platelet counts at diagnosis and decreased platelet counts during follow‐up are useful predictors of esophageal varices in patients with early PBC.