Liver Stiffness Measurement in Children Using FibroScan: Feasibility Study and Comparison With Fibrotest, Aspartate Transaminase to Platelets Ratio Index, and Liver Biopsy

Lédinghen, Victor de; Bail, Brigitte Le; Rebouissoux, Laurent; Fournier, C.; Foucher, Juliette; Miette, Véronique; Castéra, Laurent; Sandrin, Laurent; Merrouche, Wassil; Lavrand, F.; Lamireau, T.

doi:10.1097/mpg.0b013e31812e56ff

Cited by 237 publications

(224 citation statements)

References 27 publications

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“…The same association of fibrosis with normal hepatic biochemical parameters was reported in youngest children: 55% of biopsies with fibrosis and 37% (3/8 patients) with cirrhosis were obtained in patients without evidence of biochemical cholestatis (Fitzgibbons et al, 2010). These results raise the issue of systematic LB and the place of new techniques such as Fibroscan (de Ledinghen et al, 2007) to monitor very longterm TPN in the attempt to detect infra-biochemical liver complications. Further multicenter trials are needed to answer to this important clinical question.…”

Section: Discussionsupporting

confidence: 56%

Prevalence of liver complications in children receiving long-term parenteral nutrition

et al. 2011

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Background/Objectives: The hepatic prognosis of long-term home total parenteral nutrition (TPN)-dependent children is poorly documented. The objective was to study outcome data in home TPN-dependent children and to describe precisely their liver biopsies in the attempt to analyze risk factors for biochemical and histological hepatic abnormalities. Subjects/Methods: Medical records of 42 children receiving home TPN for more than 2 years between January 1998 and December 2007 in a single approved home total parenteral center were reviewed. Hepatic biochemical abnormalities were analyzed. Hepatic biopsies were classified by two independent pathologists. Results: Duration of TPN was 7.9 ± 0.8 years (mean ± s.e.m.), with an average age at onset of 1.5 ± 0.5 years. A total of 24 patients (57%) developed biochemical liver abnormalities in an average of 2.9±0.4 years after starting TPN. Risk factors for biochemical abnormalities were younger age at TPN commencement, longer duration of TPN, higher rate of catheter-related infections and higher volume and energy content of TPN. Liver biopsies were carried out in 43% of patients (mean age 3.2±0.9 years). Almost all patients had fibrosis (94%). Risk factors were dependent on each histological abnormality: fibrosis was significantly associated with a shorter length of bowel and a longer duration of TPN; cholestasis correlated with a lower percentage of total parenteral energy intake due to lipids; and steatosis had no risk factor identified. Conclusion: Our study reports a high rate of histological liver abnormalities and analyzes risk factors in children who underwent very long-term home TPN.

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Section: Discussionsupporting

confidence: 56%

Prevalence of liver complications in children receiving long-term parenteral nutrition

et al. 2011

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“…On the basis of the German guidelines for diagnosis and treatment of OW children and adolescents, 13 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].98 years, 58% males) were examined and evaluated at one of the participating centers for being OW or ob, and their initial measurement of liver enzymes were also recorded. The weight status was recorded as body mass index (BMI).…”

Section: Methodsmentioning

confidence: 99%

“…Liver stiffness measurement using Fibroscan may be a promising new sonographic alternative tool being used in the near future. 8 In a recent study, 176 ob children and adolescents with elevated aminotransferase underwent liver biopsy and the clinical correlates of pediatric NASH were analyzed. Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and g-glutamyltransferase were recorded because of the correlation with fibrosis severity.…”

Section: Introductionmentioning

confidence: 99%

Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents

et al. 2010

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Objective: Comorbidities of childhood obesity challenge health-care systems in Europe. Further, there is a lack of populationspecific prevalence data and diagnostic strategies available, especially for obesity-related disturbances of liver function. Therefore, the prevalence of elevated liver enzymes and their relationship to biological parameters were studied in a large pediatric obesity cohort. Methods: In 111 specialized pediatric obesity centers in Germany, Austria and Switzerland, 16 390 children and adolescents (age 12.4 ± 2.6 years, 58% boys) were categorized as overweight (body mass index (BMI) 490th percentile) and obese (497th percentile) and studied for related comorbidities, especially nonalcoholic fatty liver disease (NAFLD; as defined by aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) 450 U l À1 ). Data were collected using a standardized software program (APV) for longitudinal multicenter documentation. Pseudonymized data were transmitted for central statistical analysis. Results: In this pediatric cohort, 16% of the study population was overweight, 46% obese and 35% extremely obese (499.5th percentile extreme obesity (Xob)). NAFLD was present in 11% of the study population, but predominantly in boys (boys vs girls; 14.4:7.4%; Po0.001), in Xob (obese vs Xob; 9.5:17.0%; Po0.001) and in older age (o 12 vs X12 years; 8:12%; Po0.001; adjusted for BMI). ALT 450 U l À1 was significantly associated with fasting insulin and BMI-SDS. In multiple logistic regression models, Xob and male gender were strongly associated with NAFLD (odds ratio Xob vs normal weight ¼ 3.2; boys vs girls OR ¼ 2.3). Conclusion: In a large cohort of overweight and obese European children and adolescents, markers of nonalcoholic liver disease, especially ALT, are frequent and predicted by Xob and male gender. The results underline the epidemiological dimension of this obesity-related morbidity even in childhood. Therefore, at least ALT is recommended as a screening parameter in basic care.

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“…A study performed on 116 children, with a mean age of 10 years, con-cluded that liver stiffness measurement is feasible in children, and is correlated with liver fibrosis. The FibroScan equipped with a specific probe could become a useful tool for managing chronic liver diseases in the paediatric population [6].…”

Section: Hepatitis C In Childrenmentioning

confidence: 99%

Chronic hepatitis C in children is a mild and curable liver disease

Marco¹

2011

Digestive and Liver Disease

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Liver Stiffness Measurement in Children Using FibroScan: Feasibility Study and Comparison With Fibrotest, Aspartate Transaminase to Platelets Ratio Index, and Liver Biopsy

Cited by 237 publications

References 27 publications

Prevalence of liver complications in children receiving long-term parenteral nutrition

Prevalence of liver complications in children receiving long-term parenteral nutrition

Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents

Chronic hepatitis C in children is a mild and curable liver disease

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