Dynamic changes in liver stiffness during the course of acute hepatitis A

Yeon Seok Seo, Kwang Gyun Lee, Eun Suk Jung, Hyonggin An, Sanghoon Park, Bora Keum, Hyung Joon Yim, Yoon Tae Jeen, Hoon-Jai Chun, Chang Duck Kim, Ho Sang Ryu, Soon-Ho Um

Research output: Contribution to journalArticle

10 Citations (Scopus)

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. Material and 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 12 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 (≤ 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.

Original languageEnglish
Pages (from-to)449-456
Number of pages8
JournalScandinavian Journal of Gastroenterology
Volume45
Issue number4
DOIs
Publication statusPublished - 2010 Apr 14

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Hepatitis A
Liver
International Normalized Ratio
Alanine Transaminase
Bilirubin
Inflammation
Serum

Keywords

  • Elastography
  • International normalized ratio
  • Necroinflammation
  • Overestimation
  • Stiffness

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Dynamic changes in liver stiffness during the course of acute hepatitis A. / Seo, Yeon Seok; Lee, Kwang Gyun; Jung, Eun Suk; An, Hyonggin; Park, Sanghoon; Keum, Bora; Yim, Hyung Joon; Jeen, Yoon Tae; Chun, Hoon-Jai; Kim, Chang Duck; Ryu, Ho Sang; Um, Soon-Ho.

In: Scandinavian Journal of Gastroenterology, Vol. 45, No. 4, 14.04.2010, p. 449-456.

Research output: Contribution to journalArticle

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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. Material and 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 12 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 (≤ 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.",
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T1 - Dynamic changes in liver stiffness during the course of acute hepatitis A

AU - Seo, Yeon Seok

AU - Lee, Kwang Gyun

AU - Jung, Eun Suk

AU - An, Hyonggin

AU - Park, Sanghoon

AU - Keum, Bora

AU - Yim, Hyung Joon

AU - Jeen, Yoon Tae

AU - Chun, Hoon-Jai

AU - Kim, Chang Duck

AU - Ryu, Ho Sang

AU - Um, Soon-Ho

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N2 - 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. Material and 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 12 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 (≤ 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.

AB - 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. Material and 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 12 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 (≤ 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.

KW - Elastography

KW - International normalized ratio

KW - Necroinflammation

KW - Overestimation

KW - Stiffness

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