Prevalence and associated factors with esophageal varices in early primary biliary cirrhosis

Fusao Ikeda, Ryoichi Okamoto, Nobuyuki Baba, Shin ichi Fujioka, Bon Shoji, Kazuhisa Yabushita, Masaharu Ando, Shuji Matsumura, Junichi Kubota, Tetsuya Yasunaka, Yasuhiro Miyake, Yoshiaki Iwasaki, Haruhiko Kobashi, Hiroyuki Okada, Kazuhide Yamamoto

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16 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1320-1328
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume27
Issue number8
DOIs
Publication statusPublished - Aug 2012

Keywords

  • Early disease
  • Esophageal varices
  • Primary biliary cirrhosis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Ikeda, F., Okamoto, R., Baba, N., Fujioka, S. I., Shoji, B., Yabushita, K., Ando, M., Matsumura, S., Kubota, J., Yasunaka, T., Miyake, Y., Iwasaki, Y., Kobashi, H., Okada, H., & Yamamoto, K. (2012). Prevalence and associated factors with esophageal varices in early primary biliary cirrhosis. Journal of Gastroenterology and Hepatology (Australia), 27(8), 1320-1328. https://doi.org/10.1111/j.1440-1746.2012.07114.x