title: Frequency and characteristic features of portal hypertensive gastropathy in patients with viral cirrhosis.
abstract: OBJECTIVE
  To determine the frequency and specific characteristic features of portal hypertensive gastropathy (PHG) in cirrhosis due to viral etiology.
  
  
  METHODS
  Cross-sectional descriptive study.
  
  
  METHODS
  The Aga Khan University Hospital, Karachi, from June 2006 till June 2008.
  
  
  METHODS
  Patients with hepatitis B and C cirrhosis were included who underwent screening esophago-gastroduodenoscopy (EGD) for varices. Baveno III consensus statement was used for diagnosing PHG on endoscopy and divided them into two subgroups i.e. mild and severe. Data related to platelet/spleen ratio, MELD score and Child Turcotte Pugh (CTP) score indicating severity of cirrhosis were recorded in all patients. Findings were compared by using independent sample t-test.
  
  
  RESULTS
  Out of 360 patients who underwent screening EGD, 226 (62.8%) were males. Two hundred and eighty one (78%) had hepatitis C while 79 (22%) suffered from hepatitis B related cirrhosis. Three hundred patients (83.3%) had PHG while 71 (24%) had severe PHG. Higher proportion of esophageal varices (89.7%) was present among those who had PHG (p < 0.001). On univariate analysis lower platelet counts (117±55 vs. 167±90; p < 0.001), increased spleen size (14.1±2.9 cm vs. 12±2.4cm; p < 0.001) were found in PHG patients as compared to those without it. Similarly, lower platelet/spleen ratio was noted in patients with severe PHG (916±400 vs. 1477±899; p < 0.001). Furthermore, on multivariate analysis CTP score > 8 MELD score > 12 and platelets/spleen ratio < 900 were significantly associated factors with severe PHG.
  
  
  CONCLUSIONS
  Frequency of PHG was 83% while severe PHG was seen in 24% cases of viral hepatic cirrhosis. MELD score > 12, CTP score ³ 8 and platelets/spleen ratio < 900 were significant factors of severe PHG.
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi. shahid.ahmed@aku.edu
authors.forename: Shahid
authors.initials: S
authors.lastname: Ahmed
authors.forename: Khalid
authors.initials: K
authors.lastname: Mumtaz
authors.forename: Umair Syed
authors.initials: US
authors.lastname: Ahmed
authors.forename: Hasnain Ali
authors.initials: HA
authors.lastname: Shah
authors.forename: Shahab
authors.initials: S
authors.lastname: Abid
authors.forename: Saeed
authors.initials: S
authors.lastname: Hamid
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
mesh_terms: D003430:Cross-Sectional Studies; D058625:End Stage Liver Disease; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D012372:ROC Curve; D012720:Severity of Illness Index