Clinical Profile and Demographics of Adult Patients Having Non Alcoholic Cirrhosis - Data from a Tertiary Referral Center

Abstract

Purpose: To evaluate demographics and clinical profile of non alcoholic adult Sri Lankan cirrhotics admitted to a medical unit in a tertiary referral center. Methods: Case notes of 103 patients having chronic non alcoholic liver disease with histologically proven cirrhosis diagnosed in the principal author's unit at Sri Jayewardenepura General Hospital - Kotte from 1.1.2003 to 1.1.2008 were retrospectively analyzed with respect to clinical profile and demographics, to obtain the required data. Results: Study group had a sex distribution of male: female ratio of 83:20 (4:1). Mean age of presentation was 62.9±7.0 SD years without significant sex discrimination. At presentation evidence of ascites, deranged liver functions, upper gastrointestinal bleeding and peripheral edema were found in 29%, 24%, and 23%, 18% respectively. Abdomino pelvic ultrasound showed no abnormality, organomegaly, organomegaly with ascites and ascites alone in 38%, 35%, 24% and 3% respectively. Laboratory investigations showed following mean values. Prothrombin time 24.5±11SD seconds, APTT 40.3±10 SD seconds, platelets 15400±93000/ μSD, albumin 3.6±1SD g/dl, SGOT 90.1±161 SD IU/L, SGPT 61.4±141SD IU/L, bilirubin 2.5±2.8 SD mg/dl, Hemoglobin 10.2±2.5 SD g/dl. 95% had undergone endoscopy and 90% showed esophageal varices. Hepatitis B and C serology were negative in all while 2 had Wilson's disease and 2 had hemochromatosis. Conclusion: Mean age of presentation for both sexes were around 60 years of age with females constituting 25% of the population. On presentation vast majority had evidence of portal hypertension and endoscopy was the most accurate tool of diagnosis for the same. Prolonged prothrombin time was the single most consistent laboratory abnormality while Hepatitis B and C infections had no significant contributions towards non alcoholic cirrhosis in this part of the world. Vast majority showed presence of esophageal varices at the time of diagnosis implying that the portal hypertension was at an advanced stage.