Correlation of Serum Prolactin Level to Child Pugh Scoring System in Cirrhosis of Liver.

Abstract

With the growing incidence of liver cirrhosis among Asians, the use of a biomarker such as prolactin, indicates the severity of the disease, its complications and serves as a tool for early intervention. To compare the efficacy of serum prolactin to the Child Pugh scoring system in cirrhosis of the liver and establish that serum prolactin is an early marker for complications of cirrhosis of the liver. This was a comparative study on 60 patients admitted to the Department of General Medicine, KIMS from June 2014 to November 2015. Patients above the age of 18 years, diagnosed to have cirrhosis of the liver were included in the study. Patients having conditions/medications known to elevate prolactin levels such as cranial surgery/irradiation, pituitary disease, chronic renal failure, drugs such as neuroleptics, metoclopramide, aldosterone antagonists, etc., were excluded. All the patients were subjected to the routine work up for chronic liver disease including serum prolactin levels at admission. In the present study, the most common cause of cirrhosis was found to be alcohol (73%). The complications of cirrhosis were portal hypertension in 50 (83.3%), oesophageal varices in 39 (65%) with upper GI bleed in 22 (36.7%) patients, hepatic encephalopathy in 15 (25%) patients. Serum prolactin levels were elevated in 73% of the patients with highest levels of serum prolactin (>35 ng/ml) seen in patients of Class 'C' Child Pugh. Elevated serum prolactin was found in 66.7% of the patients with oesophageal varices, 90.9% patients with upper GI bleed and in all patients with hepatic encephalopathy (100%). Serum prolactin levels correlated with the Child Pugh score in predicting the severity of the disease. Patients with a higher serum prolactin at admission had a greater incidence of complications of cirrhosis. Hence, serum prolactin is an inexpensive, non invasive blood marker which may be used to estimate the severity and the complications of cirrhosis.