Clinical and laboratory profile of chronic liver disease patients in a tertiary hospital in Calabar, Nigeria

Abstract

Background: Chronic Liver Disease (CLD) is a medical condition commonly seen in gastroenterology practice in Nigeria. Thorough evaluation of CLD patients can be expensive; often times being unaffordable for patients and also taking a toll on existing limited health resources. Despite this, the relevant and prompt assessment of CLD patients can significantly reduce the high morbidity and mortality rates associated with this condition.

Objectives: This study aimed to demonstrate the clinical and laboratory patterns of patients with chronic hepatitis (CH), liver cirrhosis (LC) and primary liver cell carcinoma (PLCC).

Methods: This was a cross-sectional descriptive study involving consecutive CLD patients referred to the Gastroenterology unit of the University of Calabar Teaching Hospital. One hundred and six (106) patients were recruited over a 9 month period. These included CLD patients who met the eligibility criteria for CH, LC and PLCC.

Results: Thirty eight (38) patients had findings suggestive of CH, while 36 and 32 had features of PLCC and LC respectively. The predominant symptoms and signs seen among the CLD patients were fatigue (88.9%) and leg swelling (68.8%) in PLCC and LC patients respectively. While hepatomegaly (83.3%) and ascites (71.9%) where reported mostly in PLCC and LC patients respectively. Elevations in gamma-glutamyl transpeptidase (γ-GT) and alkaline phosphatase (ALP) was found to be more deranged in PLCC patients when compared to the other CLD categories and this was statistically significant (<0.005). However, an abnormal international normalized ratio and low platelet count was mostly found in LC patients and this too was statistically significant (p<0.005).

Conclusion: This study demonstrated that most of the CLD patients had symptoms and signs suggestive of decompensated liver disease, further manifested by deranged laboratory parameters such as the presence of coagulopathy mostly among LC patients and cholestasis in PLCC patients.

Keywords: Calabar, Chronic hepatitis, Liver cirrhosis, Primary liver cell carcinoma