title: Dynamic changes in liver stiffness during the course of acute hepatitis A.
abstract: OBJECTIVE
  Several recent studies have suggested that hepatic necroinflammation can alter the results of liver stiffness measurements (LSMs) obtained using the FibroScan device. However, the precise relationship between acute hepatic inflammation and LSMs remains unclear. The aim of this study was therefore to evaluate the dynamic changes in LSMs during the course of acute hepatic inflammation.
  
  
  METHODS
  Thirty-one patients with acute hepatitis A (AHA) were enrolled in this study (mean +/- SD age 29 +/- 7 years; 32.3% male). Only AHA patients who visited our hospital before their alanine aminotransferase (ALT) levels peaked were included. The day when AHA-associated symptoms began was considered as Day 0. Serum levels of ALT and bilirubin (BIL), and the international normalized ratio (INR) were measured every 2 days, as were LSMs, until the peak levels of all parameters were identified. Subsequently, these parameters were measured every 1-2 weeks until they had normalized.
  
  
  RESULTS
  Peak serum levels of ALT and BIL, the INR, and LSMs were 3723 +/- 1513 IU/l, 5.8 +/- 2.4 mg/dl, 1.3 +/- 0.3, and 11.9 +/- 5.7 kPa, respectively. The time taken for LSMs to peak from Day 0 (8 +/- 2 days) differed significantly from that for ALT (5 +/- 1 days), BIL (10 +/- 4 days), and INR (5 +/- 1 days). LSMs had normalized (< or = 5.5 kPa) in all patients at 34 +/- 17 days after Day 0. ALT level and the INR were significantly associated with peak LSMs and BIL level and the INR with the time taken for normalization of LSMs.
  
  
  CONCLUSIONS
  LSMs changed dynamically during the course of AHA. The pattern of change appears to be related to the severity of hepatic necroinflammation.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Kwang Gyun
authors.initials: KG
authors.lastname: Lee
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Jung
authors.forename: Hyonggin
authors.initials: H
authors.lastname: An
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Park
authors.forename: Bora
authors.initials: B
authors.lastname: Keum
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
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
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
mesh_terms: D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000097:blood; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D006506:Hepatitis A / Q000473:pathology*; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers