Liver elastography can predict degree of advanced fibrosis for autoimmune hepatitis in biochemical remission

Carregando...
Imagem de Miniatura
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Citação
JGH OPEN, v.7, n.4, p.272-277, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background and AimThe aim was to analyze the concordance of liver stiffness measurement (LSM) either by transient elastography (TE) or ARFI with liver biopsy in autoimmune hepatitis (AIH) patients with biochemical remission and to identify those with histological remission. Liver biopsy is still the golden standard for AIH diagnosis. However, it is an invasive procedure and these patients, most of the time, require many biopsies, so it would be valuable to search for noninvasive method that could select all these patients and keep under observation. MethodsThirty-three patients with AIH were submitted for liver biopsy to evaluate histological remission after at least 18 months of normal aminotransferases. The efficiency of LSM and fibrosis stages was tested by a receiver operating characteristic curve analysis (AUROC). ResultsOne patient (3%) was F0, 6 (18.2%) were F1, 8 (24.2%) were F2, 10 (30.3%) were F3, and 8 (24.2%) were F4, according to METAVIR. Thirteen of thirty-three (39.4%) patients did not achieve histological remission. AUROC for F4 stage was 0.83 (IC: 0.76-0.99) for TE and 0.78 (IC: 0.65-0.95) for ARFI. Optimal LSM cutoff values were 12.3 kPa (Se = 87.5%, Sp = 88%) for TE and 1.65 m/s (Se = 87.5%, Sp = 76%) for ARFI. The tests were unable to differentiate patients with histological activity from those in histological remission (P < 0.05). ConclusionTE and ARFI accurately identify liver fibrosis by METAVIR score in AIH patients with biochemical remission. No cutoff value was detected to indicate whether the patient achieved histological remission.
Palavras-chave
acoustic radiation force imaging, autoimmune hepatitis, liver biopsy, liver fibrosis, METAVIR score, transient elastography
Referências
  1. [Anonymous], 2015, J HEPATOL, V63, P237, DOI 10.1016/j.jhep.2015.04.006
  2. Arena U, 2008, HEPATOLOGY, V47, P380, DOI 10.1002/hep.22007
  3. Bedossa P, 2003, HEPATOLOGY, V38, P1449, DOI 10.1016/j.hep.2003.09.022
  4. Bravo AA, 2001, NEW ENGL J MED, V344, P495, DOI 10.1056/NEJM200102153440706
  5. Castera L, 2005, GASTROENTEROLOGY, V128, P343, DOI 10.1053/j.gastro.2004.11.018
  6. Castera L, 2011, BEST PRACT RES CL GA, V25, P291, DOI 10.1016/j.bpg.2011.02.003
  7. Chan HLY, 2009, J VIRAL HEPATITIS, V16, P36, DOI 10.1111/j.1365-2893.2008.01037.x
  8. Dhaliwal HK, 2015, AM J GASTROENTEROL, V110, P993, DOI 10.1038/ajg.2015.139
  9. Dietrich CF, 2017, ULTRASCHALL MED, V38, pE52, DOI 10.1055/a-0641-0076
  10. Hartl J, 2016, J HEPATOL, V65, P769, DOI 10.1016/j.jhep.2016.05.023
  11. Kim SU, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0032233
  12. Lohse AW, 2011, J HEPATOL, V55, P171, DOI 10.1016/j.jhep.2010.12.012
  13. Manns MP, 2015, J HEPATOL, V62, pS100, DOI 10.1016/j.jhep.2015.03.005
  14. Manns MP, 2010, HEPATOLOGY, V51, P2193, DOI 10.1002/hep.23584
  15. Paranagua-Vezozzo DC, 2017, WORLD J HEPATOL, V9, P436, DOI 10.4254/wjh.v9.i8.436
  16. PICCININO F, 1986, J HEPATOL, V2, P165, DOI 10.1016/S0168-8278(86)80075-7
  17. Rousselet MC, 2005, HEPATOLOGY, V41, P257, DOI 10.1002/hep.20535
  18. Sandrin L, 2003, ULTRASOUND MED BIOL, V29, P1705, DOI 10.1016/j.ultrasmedbio.2003.07.001
  19. Seeff LB, 2010, CLIN GASTROENTEROL H, V8, P877, DOI 10.1016/j.cgh.2010.03.025
  20. Seo YS, 2015, LIVER INT, V35, P2246, DOI 10.1111/liv.12808
  21. Talwalkar JA, 2007, CLIN GASTROENTEROL H, V5, P1214, DOI 10.1016/j.cgh.2007.07.020
  22. Terrabuio D., 2006, 20 YEARS AUTOIMMUNE
  23. Vergani D, 2004, J HEPATOL, V41, P677, DOI 10.1016/j.jhep.2004.08.002
  24. Wu SS, 2019, HEPATOL INT, V13, P91, DOI 10.1007/s12072-018-9907-5
  25. Xu QY, 2017, J GASTROEN HEPATOL, V32, P639, DOI 10.1111/jgh.13508