الفهرس 
PORTAL HYPERTENSIONOnly 14 pages are availabe for public view
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Abstract
Background: Propranolol is used in primary and secondary prevention of variceal bleeding in both patients with cirrhosis and non-cirrhotic portal hypertension. CYP2D6 is the rate-limiting enzyme for the metabolism of propranolol and is involved in phase I metabolism of propranolol.
Aim of the work: To investigate the impact of CYP2D6 genotypes and phenotypes on response to propranolol in patients with presinusoidal portal hypertension.
Subjects and Methods: Molecular characterization of CYP2D6 genotypes and phenotypes were studied using PGX-CYP2D6 Strip Assay among a sample of Egyptian children with presinusoidal portal hypertension (normal liver parenchyma) on propranolol. The median age of the patients was 9.5 (range2 – 18 years) years. Eighteen (60%) patients were males and 12(40%) were females. Eleven (36.7%) patients were diagnosed with portal vein thrombosis while 19(63.3%) had congenital hepatic fibrosis.
Results: In the current study, 56.7% of the patients were poor metabolizers (PMs) while 43.3% were extensive metabolizers (EMs). The effective dose of propranolol was 3.35±2.25 (range 0.4-6) mg/kg in PMs versus 3.17±1.88 (range 0.5-6) mg/kg in EMs. There was no significant difference between PMs and EMs as regards side effects, Fibroscan results, liver function tests and response to propranolol.
Conclusion: The response to propranolol in children with presinusoidal portal hypertension is not affected by CYP2D6 genotypes and phenotypes