b-Blocker therapy ameliorates XXXX due to portal hypertension in @entity1 .

@entity1169 @entity1 @entity882 @entity409 @entity381 @entity6118
BACKGROUND/PURPOSE: @entity882 due to @entity6118 precludes percutaneous liver biopsy in many cases of @entity409 ( @entity409 ). The aim of this study was to assess the efficacy of @entity1169 in correcting platelet counts (>100,000/mm(3)) to ensure percutaneous liver biopsy in @entity1 with @entity409 . METHODS: From January 2005 to December 2012, 51 consecutive @entity1 (mean age 11.5      3.0  years, 34 @entity1 ) with @entity409 who needed liver biopsy but could not be done due to @entity882 (platelets <100,000/mm(3) and/or total leukocyte counts <4,000/mm(3) with @entity381 ) were recruited and given a 4-week trial of long-acting @entity1169 (1.5-2  mg/kg/day). Hemodynamic parameters and splenic artery hemodynamics by Doppler ultrasound were recorded before and after the @entity1169 trial. Response to therapy was defined as improvement of platelet counts to >= 10(5)/mm(3). RESULTS: Thirty-two (62.7  %) @entity1 responded to @entity1169 therapy and their mean platelet counts increased from 57.5      13.0  *  10(3) to 140.7      43.3  *  10(3)/mm(3), p  =  0.0001. Liver biopsy could be done in 29. While comparing responders with non-responders, baseline spleen size (7.4      3.3 vs. 12.7      4.5  cm, p  =  0.0001) and platelet counts (57.5      13.0  *  10(3) vs. 39.5      14.5  *  10(3), p  =  0.0001) were found to be significant. ROC curve suggested a cut-off value of  <=8.5  cm of spleen and >= 53,000 platelets as predictors of response. With @entity1169 , mean arterial pressure and spleen size reduced (p  <  0.05) and splenic artery resistance increased significantly (p  =  0.005) in responders. CONCLUSIONS: @entity1169 corrects @entity882 and makes liver biopsy possible in almost two-thirds of cases by reducing splenic sequestration through splenic artery vasoconstriction. The baseline spleen size and platelet counts determine the effectiveness of therapy. A trial of b-blocker is worth carrying out in cases where liver biopsy is contraindicated due to @entity882 .
