Chronic splenomegaly in Nairobi, Kenya. II. Portal hypertension.
Eighty-five patients with chronic splenomegaly and proven oesophageal varices were studied at Kenyatta National Hospital, Nairobi. The major defined groups were hepatosplenic schistosomiasis (24%), cirrhosis (20%) and portal vein occlusion (11%). Hyper-reactive malarial splenomegaly (tropical splenomegaly syndrome) was considered as the cause of oesophageal varices in only one patient. In 26% of cases liver biopsy was non-diagnostic and the extrahepatic portal vein was demonstrated radiologically to be patent. Such patients were thought to be suffering from idiopathic portal hypertension, not previously described elsewhere in Africa. Hepatitis B surface antigen was detected in 12% of controls and in 58% of patients with cirrhosis (p less than 0.001). Some serological marker of previous hepatitis B virus infection was present in 92% of patients with cirrhosis and in 79% of controls. Kamba patients from Machakos and Kitui Districts were significantly more prevalent than expected among these 85 cases of portal hypertension.
D004932:Esophageal and Gastric Varices / Q000150:complications; D006512:Hepatitis B Core Antigens / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000276:immunology; D007630:Kenya; D008103:Liver Cirrhosis / Q000150:complications; D012555:Schistosomiasis mansoni / Q000150:complications; D013163:Splenomegaly / Q000150:complications*
D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens