ABSTRACT
Background: chronic hepatitis C virus [HCV] infection has been reported in association with several extrahepatic manifestations. Chronic HCV infection is also associated with both direct and indirect effects on pulmonary tissue
Purpose: to evaluate phenotypes of respiratory manifestations of chronic hepatitis C virus
Patients and Methods: 1-this study was conducted on 150 Egyptian patients with chronic hepatitis C. Patients were selected from those attending the in patients and out patients clinic of the Tropical Medicine and Chest Departments, Al-Azhar University Hospital-Damietta from September 2016 to Septamber 2018. 2-also ,50 healthy subjects matched for age and sex were included as volunteer.3-consent was informed by all patients and volunteer shared in this study
Results: C.O.P.D: documented in 32 patients [21.3%].Asthma: documented in 15 patients [10%] of all patients. Air way hyperreactivity: documented in 15patients [10%] of all patients. Idiopathic pulmonary fibrosis [IPF]: is presented in 37 patients [24.6%]. Pneumonia: documented in 10 patients [6%] of all patients. Transudative pleural effusion: documented in 10 patients [6%] of all patients. Adenocarcinoma: documented in 5 patients [3.3%] of all patients. Pseudolymphoma: documented in 1 patient [0.006%] of all patients. Lung abscess: documented in 10 patient [6%] of all patients. Pulmonary embolism: documented in 5 patients [3.3%] of all patients. Hepatopulmonary syndrome: documented in 10 patients [6%] of all patients
Conclusion: Chronic hepatitis C virus infection is related to the development of several pulmonary abnormalities. These pulmonary manifestations of HCV infection are frequently underdiagnosed
Recommendations: Any patient with chronic HCV infection should be evaluated with HRCT chest and pulmonary function tests for early diagnosis of pulmonary abnormalities to prevent further complications
ABSTRACT
Screening for oesophageal varices represents an important part of the diagnostic work - up of cirrhotic patients. The non invasive assessment of the presencelabsence of oesophageal varices [OV] was done by studying the platelet count /spleen diameter and their ratio in patients with liver cirrhosis with and without OV. This study was performed on 140 patients diagnosed as having liver cirrhosis by history, clinical examination, laboratory and radiological findings. Seventy of them had no oesphageal varices NOV [group I] and 70 cases had OV [group II] were diagnosed by upper endoscopy. All patients were also classified according to modified child Turcotte-Pugh's Criteria into: Classes A,B and C [50, 60 and 30 patients respectevily]. Also, 10 normal, age and sex matched subjects were included as a control group. ultrasonographic findings revealed a high significant increased [P<0.01] of the mean bipolar spleen diameter in group 11 [166.79 +/- 25.78 mm] in comparison to group I [137.89 +/- 22.06 mm]. The mean portal vein diameter was increased in group 11 [13.54 +/- 2.39 mm] as compared to group I [11.83 +/- 1.95 mm] with a highly significant difference [P<0.01]. Color Doppler sonography demonstrated, portal vein flow direction was normal [hepato -petal] in all cases [100%] of group I. While in group II, it was reversed [hepato -fugal] in 31 patients [44.29%] , with a highly significant difference between groups 1 and 11 [p < 0.01]. According to Modified Child Turcotte Pugh classification, there was a highly significant increase [P<0.01] in the score in group II than group I. There was a highly significant decrease in platelets count [P<0.01] in group II [113.13 +/- 66.04 mm3] in comparison to group I [167.39 +/- 95.66 mm3]. The mean of platelet count /spleen diameter ratio was highly significant decrease [P<0.01] in group II [71 1.44 +/- 346.0] in comparison to group I [1488.74 +/- 1613.731]. As regards the correlation between that ratio and some parameters, we found that in group I, there was highly significant correlation between the studied ratio and platelet count, spleen diameter and modified child score. Also In group II, there was highly significant statistical correlation between the ratio and the platelet count and spleen diameter but no correlation with modified child score. The diagnostic accuracy of platelets count ,maximum bipolar spleen diameter and the portal vein diameter, as a non-invasive parameters in the detection of the presence of OV was [68%] [66%] and [65%] respectively. Concerning the studied ratio, the cut-off value was <739, with sensitivity [67.14%], specificity [62.86%], positive predictive value [64.38%] and negative predictive value [65.67%], while the diagnostic accuracy was [72.5%] as a non-invasive method in the detection of the presence of OV. In conclusion, the cut off -value of the platelet count/spleen diameter ratio 5739 is the only parameter which carries the best diagnostic accuracy and is independently associated with the presence of OV in patients with liver cirrhosis