Diagnosis of liver fibrosis using FibroScan and other noninvasive methods in patients with hemochromatosis: a prospective study.
BACKGROUND
The role of hepatic iron overload in the development of hepatic fibrosis in patients with hemochromatosis is well-established. Transient elastography (FibroScan) is a new noninvasive, rapid, reproducible bedside method, allowing assessment of liver fibrosis by measuring liver rigidity.


OBJECTIVE
The aim of this prospective study was to evaluate liver fibrosis with FibroScan and other noninvasive biochemical methods in patients with hemochromatosis (C282Y homozygosity) compared with control patients.


METHODS
From January 2004 through October 2006, all consecutive patients with hemochromatosis were evaluated for liver fibrosis using noninvasive methods (FibroScan and biochemical markers). These patients were compared with patients who had chronic cytolysis and no fibrosis on liver biopsy.


RESULTS
One hundred and three consecutive patients (57 cases and 46 controls) were fully investigated. Median FibroScan values were similar in both groups, 5.20 kPa versus 4.9 kPa, respectively. No differences were observed between cases and controls for all biochemical markers. A strong correlation was observed between FibroScan and many biochemical markers, although ferritin levels did not correlate with FibroScan values. The prevalence of patients with FibroScan values greater than 7.1 kPa (cut-off level for significant fibrosis) was 22.8% in patients with hemochromatosis and 0% in the controls (P<0.0001).


CONCLUSIONS
FibroScan and biochemical markers could be reliable noninvasive methods for detecting liver fibrosis in patients with hemochromatosis. Such patients have high FibroScan values more often than do control patients. Further longitudinal and prospective studies are necessary to confirm these preliminary data.
Adhoute
X
X
Service d'hépatogastroentérologie, centre d'investigation de la fibrose hépatique, hôpital Haut-Lévêque, 33604 Pessac cedex, France.
Foucher
J
J
Laharie
D
D
Terrebonne
E
E
Vergniol
J
J
Castéra
L
L
Lovato
B
B
Chanteloup
E
E
Merrouche
W
W
Couzigou
P
P
de Lédinghen
V
V
D000367:Age Factors; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003545:Cysteine; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D006432:Hemochromatosis / Q000150:complications* / Q000235:genetics; D006720:Homozygote; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014443:Tyrosine
D015415:Biomarkers; D014443:Tyrosine; D005293:Ferritins; D001219:Aspartate Aminotransferases; D003545:Cysteine