Year 2008 / Volume 100 / Number 10
Original
Utility of various non-invasive methods for fibrosis prediction among Basque Country patients with phenotypic hemochromatosis

pp. 611-614

Castiella, A. / Zapata, E. / Otazua, P. / Fernández, J. / Alustiza, J. M. / Ugarte, M. / Legasa, L. / Galardi, A. / Ugalde, A. / Barredo, I. / Arriola, J. A.

Abstract
Objective: to determine whether the product of multiplying age by liver iron concentration (LIC) (fibrosis index; cut-off, 480,000), platelets, transaminases, and ferritin values are related to the risk of high grade fibrosis.

Methods: a retrospective study of 32 patients with hereditary hemochromatosis (HH) with phenotypic expression. All patients had a liver biopsy with LIC.

Results: in 7 patients a magnetic resonance imaging (MRI) scan (1.5 T) was obtained with LIC following Alustiza’s protocol. Liver biopsy: fibrosis grade (F) 0-2 in 23 patients; F 3-4 in 9. Fibrosis index (FI) showed a specificity of 68%, sensitivity of 85.7%, positive predictive value (PPV) of 42.8%, and negative predictive value (NPV) of 94.4% for high-grade fibrosis. Platelet count ( < 200,000) revealed a NPV of 94.7% for F3-4. Aspartate transaminase (AST) levels above the upper limit of normal showed a NPV of 94.4%; ferritin levels (> 1,000) a NPV of 75%, and MRI-derived LIC x age (> 480,000) a NPV of 80%. The combination of FI (either by biopsy or MRI) with transaminases, and of platelets with transaminases revealed a NPV of 100%.

Conclusions: FI > 480,000 and platelets < 200,000 have the highest sensitivity for high-degree fibrosis prediction. A negative result allows to discard significant fibrosis in 94% of cases. MRI allows a good fibrosis prediction.
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Castiella, A. / Zapata, E. / Otazua, P. / Fernández, J. / Alustiza, J. M. / Ugarte, M. / Legasa, L. / Galardi, A. / Ugalde, A. / Barredo, I. / Arriola, J. A.. Utility of various non-invasive methods for fibrosis prediction among Basque Country patients with phenotypic hemochromatosis. 611-614


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