title: Changes in liver stiffness during the course of acute hepatitis A.
abstract: OBJECTIVE
  In some patients with chronic hepatitis, liver stiffness (LS) findings do not reflect fibrosis stage. This study was performed to evaluate whether acute liver inflammation could influence LS findings.
  
  
  METHODS
  Patients with acute hepatitis A admitted to our hospital were included. Hepatitis was classified on admission using serum ALT and bilirubin levels as inflammation phase, jaundice phase, or recovery phase. Patients who admitted during the recovery phase (whose ALT and bilirubin levels fell continuously during hospitalization) and therefore, their peak-ALT and peak bilirubin levels could not be determined were exduded. Enrolled patients underwent FibroScan during hospitalization and after discharge.
  
  
  RESULTS
  Seventy-six patients with acute hepatitis A were enrolled (median age, 29 years; 46 men and 30 women). Among them, 33 (43.4%) and 43 (56.6%) patients were admitted during the inflammation phase and jaundice phase, respectively. For patients admitted during the inflammation phase, mean (+/-SD) time from symptom-onset day to maximum ALT level was 7 (+/-3) days. For all patients, mean time from symptom-onset to maximum bilirubin level was 11 (+/-4) days. Mean LS during admission was 8.9 (+/-Pa (median, 8.4 kPa). LS was significantly correlated with serum bilirubin level, which was the only factor found to be significantly associated with the increased LS (>7.08 kPa). In all patients, LS increased gradually from the symptom-onset and peaked at 8-9 days later.
  
  
  CONCLUSIONS
  Severe hepatic inflammation can affect the LS findings and thus, care is required when assessing fibrosis stage using LS measurement in patients with severe inflammation.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Sang-Jun
authors.initials: SJ
authors.lastname: Suh
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Jung
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Jang
authors.forename: Yong Dae
authors.initials: YD
authors.lastname: Kwon
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Bora
authors.initials: B
authors.lastname: Keum
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Kim
authors.forename: Yoon Tae
authors.initials: YT
authors.lastname: Jeen
authors.forename: Hoon Jai
authors.initials: HJ
authors.lastname: Chun
authors.forename: Chang Duck
authors.initials: CD
authors.lastname: Kim
authors.forename: Ho Sang
authors.initials: HS
authors.lastname: Ryu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D054459:Elasticity Imaging Techniques; D005260:Female; D006506:Hepatitis A / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D012189:Retrospective Studies
chemical_list: D000410:Alanine Transaminase; D001663:Bilirubin