Non‐invasive assessment of liver fibrosis in C282Y homozygous HFE hemochromatosis

Abstract

An algorithm that successively employed SF and TE can accurately classify severe fibrosis in 61% of patients, restricting the need for liver biopsy to the 39% of patients with intermediate or unvalid TE values. This algorithm should be validated in independent cohorts before extended use.

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

“…In addition, spleen stiffness may be a predictor of esophageal varices and bleeding risk (76,77). In patients with hemochromatosis, an algorithm that uses serum ferritin levels together with transient elastography was shown to accurately determine the presence of severe fibrosis in 61% of patients, obviating the need for liver biopsy in this group (78). Advanced MR elastographic techniques have been developed to perform MR elastography in patients with mild to moderate iron overload (79).…”

Clinical management of hemochromatosis: current perspectives

“…Brissot et al MRI has largely replaced the liver biopsy, which is no more performed for the diagnosis of iron overload due to its invasiveness, except in case of MRI unavailability or contraindication or when liver biopsy could provide additional information, especially associated liver lesions or hepatic fibrosis (but even in the latter situation, biochemical tests of fibrosis 23 combined with transient elastography 24 are increasingly replacing histological determination).…”

Diagnosis and therapy of genetic haemochromatosis (review and 2017 update)

“…The shear wave velocity correlates with liver stiffness, most accurately at the lower and higher ends of the range. In homozygotes with raised transaminases or SF values >1000 μg/l a TE <6·4 kPa excluded significant fibrosis whereas TE >13·9 kPa was predictive for severe fibrosis (Legros et al , ). Serum hyaluronic acid measurement has also shown excellent sensitivity and specificity for cirrhosis when values >46·5 ng/ml are obtained but this assay is not in routine clinical use (Crawford et al , ).…”