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Subject Area

Community Medicine

Article Type

Original Study

Abstract

Objective The aim was to determine the role of plasma free serotonin concentrations on the development of esophageal and gastric fundal varices. Background Esophageal and gastric varices are a serious consequence of portal hypertension in patients with the chronic liver disease. Several studies have evaluated possible noninvasive predictors for the presence of varices including plasma serotonin level. Materials and methods This study was conducted on 100 patients: 60 hepatic patients with esophageal and/or gastric varices, 20 hepatic patients without varices, and 20 nonhepatic patients who were admitted to Tropical Medicine Department in Menoufia University Hospitals. Patients and control were subjected to laboratory investigations, abdominal ultrasound, upper endoscopy, and quantitative measurement of plasma free serotonin using enzyme-linked immunosorbent assay technique. Results The plasma free serotonin levels were much higher in patients with liver cirrhosis with varices than in nonhepatic patients (mean: 92.240 ± 18.534 vs. 20.015 ± 3.042 ng/ml; P < 0.0001). Moreover, plasma serotonin level was much higher in patients with varices than patients without varices (mean: 92.240 ± 18.534 vs. 42.220 ± 9.891 ng/ml; P < 0.0001). The best cutoff value of free serotonin in the prediction of esophageal and gastric varices was greater than or equal to 25.3 ng/ml, with sensitivity of 98.75%, specificity of 100%, positive predictive value of 100.0%, and negative predictive value of 95.2%. Conclusion Free serotonin is significant in the development of esophageal and fundal varices, indicating the clinical value of serotonergic receptor blockers in these patients.

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