Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
10.5223/pghn.2025.28.2.101
- Author:
Nehal El KOOFY
1
;
Sawsan Hassan OKASHA
;
Hala Mounir AGHA
;
Noha ALI
;
Ahmed Said BEHAIRY
;
Hanan Mina FOUAD
;
Rehab Hamdy ZAWAM
Author Information
1. Department of Pediatric, Faculty of Medicine, Cairo University, Cairo, Egypt
- Publication Type:Original Article
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2025;28(2):101-112
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion:POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
