title: Transient elastography in the assessment of liver fibrosis in adult thalassemia patients.
abstract: Transient elastography (TE) is a valuable noninvasive technique of measuring liver stiffness and a reliable tool for predicting hepatic fibrosis in patients with chronic liver disease. The role of TE in patients with beta-thalassemia has not been extensively investigated. The present study aimed to evaluate the role of TE in the assessment of hepatic fibrosis in 115 adult patients with beta-thalassemia major (TM) (#59) or intermedia (TI) (#56). TE was performed according to current practice. Histologic data were obtained in 14 cases. Liver iron concentration was assessed by atomic absorption spectrometry and T2 magnetic resonance. In patients with TM, the proportion of anti-HCV positive viremic patients, median serum ferritin levels, and TE values were significantly higher than in TI. In the group of 14 patients who underwent liver biopsy, a significant positive correlation was observed between liver stiffness and fibrosis stage (r = 0.73, P = 0.003). Severe fibrosis is diagnosed with a sensitivity of 60% and a specificity of 89%, whereas cirrhosis is detected with a sensitivity of 100% and a specificity of 92%. At multivariate analysis, the variables independently associated with TE were ALT, GGT, and bilirubin levels in both groups and, in patients with TM, HCV RNA positivity. In beta-thalassemia patients, TE is a reliable tool for assessing liver fibrosis even if the influence of iron overload has to be clarified.
authors.affiliation: Second Division of Gastroenterology, Foundation IRCCS Cà Granda, Maggiore Policlinico Hospital and University of Milan, Milan, Italy.
authors.forename: Mirella
authors.initials: M
authors.lastname: Fraquelli
authors.forename: Elena
authors.initials: E
authors.lastname: Cassinerio
authors.forename: Alberto
authors.initials: A
authors.lastname: Roghi
authors.forename: Cristina
authors.initials: C
authors.lastname: Rigamonti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casazza
authors.forename: Massimo
authors.initials: M
authors.lastname: Colombo
authors.forename: Sara
authors.initials: S
authors.lastname: Massironi
authors.forename: Dario
authors.initials: D
authors.lastname: Conte
authors.forename: Maria Domenica
authors.initials: MD
authors.lastname: Cappellini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D005293:Ferritins / Q000032:analysis; D019698:Hepatitis C, Chronic / Q000150:complications / Q000473:pathology; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D019190:Iron Overload / Q000209:etiology / Q000473:pathology; D007558:Italy; D008099:Liver / Q000737:chemistry / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016037:Single-Blind Method; D065227:Transfusion Reaction; D014766:Viremia / Q000150:complications; D055815:Young Adult; D017086:beta-Thalassemia / Q000150:complications*
chemical_list: D005293:Ferritins; D007501:Iron