Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
November 2017 Vol. 6(11), pp. 302-309
Copyright © 2017 Global Advanced Research Journals

Full Length Research Paper

Significance of von Willebrand Factor in Compensated and Decompensated Cirrhosis

Mohsen M. Maher¹*, Tarek M. Yosef¹, Wesam A. Ibrahim¹, Maha M. Hussein¹, Manal Mohsen², Ahmed S. Khayal¹, Walaa Hashem¹, Manal Ghozlan² and Emad Abd-Eldayem³.

¹Internal Medicine Department, Ain Shams University.
²Clinical Pathology Department, Ain Shams University.
³Radiology Department, Ain Shams University.

*Corresponding Author E-mail: mha.mohsen@yahoo.com, maha.mohsen.hussein@med.asu.edu.eg;                 Phones: +0201001815402, +0201159469494

Accepted 22 November, 2017

Abstract

Liver cirrhosis is associated with extensive alternations in hemostatic functions. Among these alternations, von Willebrand factor (vWF) is found to be elevated. However, its clinical significance is not well established. To demonstrate the relation between vWF level and platelet function and its relation to portal hypertension in patients with liver cirrhosis of different severity. 70 patients with liver cirrhosis were compared to 20 healthy control subjects. For all participants; vWF antigen (Ag) was measured by enzyme-linked immunosorbent assay. von Willebrand factor: ristocetin cofactor activity (vWF:RCo) –a measure of ability of vWF to interact with platelet glycoprotein Ib-was measured by agglutination technique. Ratio between vWF: RCo to VWF Ag which reflects the functional capacity of vWF was calculated (RCo/Ag ratio). Portal hypertension (PH) was assessed in patients group by portal vein duplex, congestion index and esophagogastroduodenoscopy (EGD). vWF Ag and vWF:RCo are significantly increased in patients group compared to control (31.6µg/ml and 94.5% compared to 9.4µg/ml and 65.3% respectively) while RCo/Ag ratio is significantly lower in patients group compared to control (4.2 and 8.6 respectively) indicating a reduction in the functional capacity of vWF. There is a significant positive correlation between vWF Ag and Child Pugh score of the patients and a strong positive correlation between vWF Ag and severity of PH. vWF level at cut off value 14.85µg/ml can predict PH with 98.1% sensitivity and 88.9% specificity. vWF Ag and vWF: RCo are increased in patients with liver cirrhosis. Their increase is positively correlated with severity of liver cirrhosis and partially compensate for reduced platelet count. vWF Ag is sensitive and non-invasive predictor of PH.

Keywards: vWF, ristocetin, liver Cirrhosis, portal hypertension.

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