Background and study aim: Variceal hemorrhage (VH) is a deadly consequence of liver cirrhosis with six-week mortality rates ranging between 12% and 22% after an attack of bleeding. Esophagogastroduodenoscopy EGD is a gold standard for the diagnosis and management of varices however; it is an invasive procedure, which necessitates searching for non-invasive markers for varices prediction which might decrease the frequency of performing EGD. Therefore our study aimed to assess the validity of serum interleukin 18 (IL-18) in predicting the development of oesophageal varices (OV) in HCV cirrhotic patients, and to correlate its level with the grade of OV.
Patients and Methods: The study included 90 subjects categorized into 2 main groups: group I: 60 HCV cirrhotic patients classified into the two subgroups: Group IA (n= 30) HCV patients not having esophageal varices, Group IB (n=30) HCV patients with different grades of varices, and Group II (n=30) healthy individual. Physical evaluation and laboratory tests including Serum IL18 ELISA assay were done for studied groups. EGD with grading of varices was done for patient groups using Paquet classification, with assessment of variceal risk signs of bleeding, and portal hypertensive gastropathy.
Results: HCV cirrhotic patients displayed significantly higher IL18 levels than healthy controls. With more increase in the presence of varices, moreover IL18 level correlated significantly with portal hypertensive gastropathy.
Conclusion: Serum IL18 can be utilized as a non-invasive marker for predicting esophageal varices among HCV cirrhotic patients with good specificity and sensitivity, also its level correlated with grade of varices, bleeding risk signs, and the presence of PHG.