title: Transient elastography of the liver in children with Wilson's disease: Preliminary results.
abstract: OBJECTIVE
  In chronic liver diseases, liver stiffness (LS) is increased, primarily because of liver fibrosis, but other factors, such as intrahepatic deposits, may also be involved. We hypothesized that intrahepatic copper accumulation occurring in Wilson's disease (WD) also leads to an increase in LS. The aim of this study was thus to investigate the changes in LS during treatment in pediatric patients with WD.
  
  
  METHODS
  Consecutive patients younger than 18 years old, whose WD was diagnosed between 2008 and 2013, were enrolled. All patients underwent testing for liver function and urinary copper excretion, and LS was measured on transient elastography at baseline and at 6- to 12-month intervals during specific therapy.
  
  
  RESULTS
  Nine patients were included in the analysis; only two were diagnosed with cirrhosis. The median LS decreased during treatment from 15.1 kPa (range, 5.1-66 kPa) at baseline to 10 kPa (4-16.1 kPa) at follow-up interval 1, and to 6.1 kPa (3.9-11.6 kPa) at follow-up interval 2 (p < 0.0001). In parallel, the differences in urinary copper excretion over the follow-up period were not statistically significant, although the decrease in LS correlated with the increase in urinary copper excretion (r = 0.6).
  
  
  CONCLUSIONS
  In pediatric patients with WD, LS is high at the time of diagnosis and decreases during specific treatment, in parallel with an increase in the urinary copper concentration.
authors.affiliation: 2nd Pediatric Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Stefanescu
authors.affiliation: 2nd Pediatric Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
authors.forename: Tudor Lucian
authors.initials: TL
authors.lastname: Pop
authors.affiliation: Hepatology Unit, Regional Institute of Gastroenterology and Hepatology, Cluj Napoca, Romania.
authors.forename: Horia
authors.initials: H
authors.lastname: Stefanescu
authors.affiliation: 2nd Pediatric Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Miu
mesh_terms: D000293:Adolescent; D002648:Child; D003300:Copper / Q000652:urine; D054459:Elasticity Imaging Techniques; D005355:Fibrosis / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006527:Hepatolenticular Degeneration / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging
chemical_list: D003300:Copper
keywords: Wilson's disease; children; liver fibrosis; liver stiffness; transient elastography; ultrasonography