Liver stiffness measurement using FibroScan is influenced by serum total bilirubin in acute hepatitis.
BACKGROUND
Liver stiffness measurement (LSM) using FibroScan is accepted as a highly reproducible and accurate technique for assessment of liver fibrosis. However, several studies have indicated that the LSM value can be significantly influenced by major changes in aminotransferases in patients with chronic viral hepatitis and LSM is unreliable for diagnosing underlying liver cirrhosis in patients with acute liver damage. We aimed to determine biochemical factors influencing the LSM value in patients with acute hepatitis.


METHODS
From July to December 2007, a total of 60 patients with acute hepatitis of varying aetiologies were recruited prospectively. LSM and biochemical tests were performed at diagnosis and recovery from acute hepatitis.


RESULTS
The mean age of the patients (38 men and 22 women) was 40.7+/-15.4 years. The aetiology of acute hepatitis included hepatitis A virus in 31 patients, drug induced in 19 and hepatitis B virus in 10. The mean LSM value was 19.6 kPa at diagnosis and 15.9 kPa at recovery. Correlation analysis showed that the LSM value at diagnosis was significantly associated with platelet count (P=0.023), alanine aminotransferase (P=0.045), albumin (P<0.001), total bilirubin (P=0.004) and prothrombin time (P=0.005). However, additional correlation analysis between the changes in LSM value and biochemical factors from diagnosis to recovery showed that the change in total bilirubin was found to be the only factor associated with the change in the LSM value (P<0.001).


CONCLUSIONS
Our data suggest that the LSM value might be influenced by serum total bilirubin in patients with acute hepatitis without pre-existing underlying chronic liver disease.
Kim
Seung Up
SU
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Han
Kwang-Hyub
KH
Park
Jun Yong
JY
Ahn
Sang Hoon
SH
Chung
Moon Jae
MJ
Chon
Chae Yoon
CY
Choi
Eun Hee
EH
Kim
Do Young
DY
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006505:Hepatitis / Q000473:pathology*; D006801:Humans; D007723:Korea; D016014:Linear Models; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time
D000410:Alanine Transaminase; D001663:Bilirubin