BACKGROUND: Esophageal varices (EV) are a complication of cystic fibrosis-associated liver disease. Esophagogastroduodenoscopy (EGD) is currently used to diagnose varices but is invasive for pediatric patients. The goal of this study was to explore the relationship between transient elastography (FibroScan®) and the presence of EV in patients with liver disease defined by clinical, laboratory, sonographic, and/or endoscopic criteria. METHODS: 18 patients with cystic fibrosis underwent EGD and transient elastography. 12 patients had EV. RESULTS: Patients with EV had higher FibroScan values than those without varices with median values of 22.4 kPa (14.4-30.4 kPa) vs. 7.9 kPa (4.4-13.7 kPa) (p=0.01). Using a threshold of 12 kPa, four of six patients without EV would not have needed EGD. CONCLUSIONS: Elastography should be recommended for all cystic fibrosis patients with liver disease to follow its progression. A prospective study is needed to define an elastography threshold value that predicts the presence of EV.
BACKGROUND: Esophageal varices (EV) are a complication of cystic fibrosis-associated liver disease. Esophagogastroduodenoscopy (EGD) is currently used to diagnose varices but is invasive for pediatric patients. The goal of this study was to explore the relationship between transient elastography (FibroScan®) and the presence of EV in patients with liver disease defined by clinical, laboratory, sonographic, and/or endoscopic criteria. METHODS: 18 patients with cystic fibrosis underwent EGD and transient elastography. 12 patients had EV. RESULTS:Patients with EV had higher FibroScan values than those without varices with median values of 22.4 kPa (14.4-30.4 kPa) vs. 7.9 kPa (4.4-13.7 kPa) (p=0.01). Using a threshold of 12 kPa, four of six patients without EV would not have needed EGD. CONCLUSIONS: Elastography should be recommended for all cystic fibrosispatients with liver disease to follow its progression. A prospective study is needed to define an elastography threshold value that predicts the presence of EV.
Authors: Marilyn J Siegel; A Jay Freeman; Wen Ye; Joseph J Palermo; Jean P Molleston; Shruti M Paranjape; Janis Stoll; Daniel H Leung; Prakash Masand; Boaz Karmazyn; Roger Harned; Simon C Ling; Oscar M Navarro; Wikrom Karnsakul; Adina Alazraki; Sarah Jane Schwarzenberg; Frank Glen Seidel; Alex Towbin; Estella M Alonso; Jennifer L Nicholas; Karen F Murray; Randolph K Otto; Averell H Sherker; John C Magee; Michael R Narkewicz Journal: J Pediatr Date: 2020-02-12 Impact factor: 4.406
Authors: Daniel H Leung; Wen Ye; Jean P Molleston; Alexander Weymann; Simon Ling; Shruti M Paranjape; Rene Romero; Sara Jane Schwarzenberg; Joseph Palermo; Estella M Alonso; Karen F Murray; Bruce C Marshall; Averell H Sherker; Marilyn J Siegel; Rajesh Krishnamurthy; Roger Harned; Boaz Karmazyn; John C Magee; Michael R Narkewicz Journal: J Pediatr Date: 2015-08-05 Impact factor: 4.406
Authors: Thomas Karlas; Marie Neuschulz; Annett Oltmanns; Andrea Güttler; David Petroff; Hubert Wirtz; Jochen G Mainz; Joachim Mössner; Thomas Berg; Michael Tröltzsch; Volker Keim; Johannes Wiegand Journal: PLoS One Date: 2012-07-25 Impact factor: 3.240