Thromboelastography versus Conventional Coagulation Tests in Pediatric Chronic Liver Disease

Document Type : Original Article

Authors

1 Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.

2 Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.

10.21608/jcmrp.2025.389435.1280

Abstract

Abstract:
Introduction: The liver is the major site for synthesizing and clearing activated haemostatic factors. Chronic liver disease (CLD) is a progressive deterioration of liver function. Consequently, in patients with liver dysfunction, a complicated disorder of the haemostatic system arises, causing both bleeding and thromboembolic complications. In the majority of patients, the etiology of CLD remains uncertain.
Aim of the Work: To compare thromboelastography test (TEG) and conventional coagulation tests (CCTs) in children with Chronic liver disease (CLD) who are admitted to Assiut University Children's Hospital and to detect the advantages of TEG in predicting the risk of bleeding and assessing haemostasis.
Methodology: This cross-sectional study was carried out at the Hepatology Unit, Assiut University Children's Hospital, and was conducted on 33 patients from the beginning of June 2023 to the end of May 2024.
Results: In CLD patients, the female predominance was noted (M:F ratio 0.94:1). The most common manifestation was abdominal pain and pallor (63.6%). ROTEM showed delayed clotting (↑CT), reduced firmness (↓MCF), and stable lysis (L30), with low FIBTEM MCF indicating fibrinogen deficiency. Metabolic liver disease was the leading cause (27.3%). Moderate positive correlations were observed between aPTT and CT/CFT, PT and CT/CFT/α angle/MCF, and INR and CT/CFT. FIBTEM MCF also correlated with platelet count.
Conclusion: There was a decline in coagulation function with increasing liver disease severity. ROTEM parameters were prolonged in severe cases, correlating with fibrinogen levels.
 

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