Liver stiffness assessed by transient elastography in patients with β thalassaemia major

Abstract

In a study with 119 patients and 183 controls, patients who had never been infected with HCV showed significantly higher LSMs than controls [5.7 (95% CI, 5.2-6.2) kPa vs. 4.3 (95% CI, 4.1-4.4) kPa, p < 0.0001]. A moderate correlation between LSMs and ferritin values, adjusted for gender and age, was found in patients (r = 0.49, p < 0.0001) but not in controls (r = -0.22, p = 0.6). No correlation between LSMs and MRI T2* or SQUID liver susceptometry values was observed. In conclusion, compared to controls β thalassaemia major patients had a significant increase in LSMs independently from HCV infection.

Noninvasive assessment and risk factors of liver fibrosis in patients with thalassemia major using shear wave elastography

“…There have been conflicting results regarding the relationship of LSM and LIC. Three important studies [10,11,22] found no correlation between LSM and LIC, whereas our study found a large and significant difference in LIC between patients with and without significant LSM. Supporting our result, a recent study [23] found that fibrosis measured by TE significantly improved as LIC improved after 4 years of chelation therapy.…”

“…Elaify et al [21] identified a very high number of TM patients with both fibrosis (35%) and cirrhosis (24%), despite studying a relatively young population and found a positive correlation with HCV seropositivity. In contrast to this, two Italian studies [11,22] found that 33.6% and 35% of their TM patients to have significant fibrosis and neither found a correlation with the HCV seropositivity. However, both of the Italian studies had older patients than in our study and had relatively high numbers of HCV RNA positive patients.…”

“…However, both of the Italian studies had older patients than in our study and had relatively high numbers of HCV RNA positive patients. The contrasting results of these studies suggest that the correlation in the Egyptian population was due to the combination of HCV viremia and the heavier iron load in that cohort (LIC of 12 vs. 5.91 and 4.58 g/g dw in the Italian studies) [11,21,22].…”

“…It is becoming an attractive technology for assessment of liver fibrosis as it is readily available, non-invasive, accurate, low cost, reproducible, and suitable for use in a variety of clinical settings. There are limited data about the role of Transient Elastography (TE) in the assessment of liver fibrosis in patients with TM and no data on the utility of the 2-D SWE imaging technique in such cases [10][11][12][13]. Therefore, the present study aimed to stage liver fibrosis in patients with TM using the 2-D SWE imaging technique in staging hepatic fibrosis and evaluating risk factors associated with significant fibrosis.…”

Treatment of chronic hepatitis C with direct‐acting antivirals in patients with β‐thalassaemia major and advanced liver disease

“…First, the use of transient elastography to determine the stage of liver disease in patients with β‐TM. Although some studies have indicated that liver stiffness measurements are not affected by the degree of iron deposition, there are some contradictory reports warning that elevated LIC could actually significantly affect liver stiffness measurements (Di Marco et al , ; Sinakos et al , ; Ferraioli et al , ). As our study reflected everyday clinical practice, transient elastography was the main tool for disease staging, also taking into account that our patients had generally low LIC values.…”