Humera Khan, Noorul Iman.
Hypoalbuminemia: a marker of oesophageal varices in chronic liver disease due to hepatitis B and C.
Rawal Med J Jan ;34(1):98-101.

Objectives To evaluate Serum albumin as a marker of Esophageal Varices (EV) in chronic liver disease (CLD) due to hepatitis B and C. Method In this prospective, cross-sectional study, patients with CLD due to HBV and HCV were assessed as per Child-Pugh class. All patients had full blood count, HBsAg, Anti-HCV antibodies by ELISA, abdominal ultrasound and Esophagogastroduodenoscopy (EGD). Patients were divided into Group A (serum albumin <3.5 gm %) and Group B (normal serum albumin). Results Ninety-seven male (49.2%) and 100 female patients (50.8%)] with age range of 15 to 80 years were evaluated. Mean Serum albumin was 3.8 gm%, (range 2.4-4.9). EV were present in 63 patients (32%) and absent in 134 patients (68%). Group A had 57 patients (28.9% of the total) with 35 patients having EV. Group B had 140 patients (71.1% of the total) with 28 patients having EV. Sensitivity of hypoalbuminemia as a marker of EV was 53.2% and specificity 91%, positive predictive value 73.3% and negative predictive value 80.8% and odds ratio was 11.57. Spearman`s rank correlation showed a significant negative correlation of `-0.494` between serum albumin and EV. ROC curve showed 70.7% area under the curve for albuminemia of <3.5 gm%. Conclusions Hypoalbuminemia is a good surrogate marker for the presence of esophageal varices in CLD due to hepatitis B and C viruses.(Rawal Med J 2009; 34: 98-101).

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