Liver stiffness measured by transient elastography is associated with hepatic Fibrosis in children with portal vein thrombosis: a retrospective cross-sectional study.

Background: Extrahepatic portal vein obstruction (EHPVO) can be idiopathic or secondary to congenital abnormalities and other conditions in the pediatric population. The severity of the disease can be accurately determined by the precise degree of hepatic fibrosis. Most cases result from portal vein thrombosis (PVT). This study aimed to evaluate the accuracy of liver stiffness measurement (LSM) compared with liver biopsy for assessing liver fibrosis in patients with PVT. Methods: This retrospective cross-sectional study included children aged 3-18 years with EHPVO/PVT who were referred to the Cairo University Children's Hospital between 1 July 2016 and 31 December 2018. All patients underwent clinical examination, routine laboratory studies, and Doppler ultrasound of the portal system. Fibrosis was staged on liver biopsy using the METAVIR scoring system. Logistic regression was used in an exploratory manner to assess factors associated with hepatic fibrosis. Results: A total of 20 children were included. Males predominated, accounting for 85%. Splenomegaly was present in 70% of patients and hepatomegaly in 20%. Hepatic fibrosis was absent in 25%, mild in 30%, and moderate in 45% of patients. FibroScan (transient elastography, TE) values were the most strongly associated with fibrosis stage, had good discriminative ability (AUROC 0.912), and appeared to outperform platelet count and liver function tests. Clinical features, including bleeding history, did not correlate with fibrosis stage. Conclusion: Platelet count and FibroScan (TE) may serve as useful indicators of hepatic fibrosis in children with PVT, with FibroScan (TE) being the strongest associated factor in this sample.