Spectrum of liver diseases in patients referred for Fibroscan: A single center experience in the Middle East

Abstract

Background Liver diseases is a worldwide etiology causing high morbidity and mortality. Fibroscan is a quick, painless examination performed in clinic or at the patient's bedside. It is used to evaluate liver status for patients with suspected liver disease prognosis. This study aims at describing the spectrum of liver diseases among patients performing Fibroscan at a tertiary care center in Lebanon. Methods This is a retrospective data collection study on patients who underwent Fibroscan at the American University of Beirut hepatobiliary unit between 2015 and 2018. Medical charts of all patients were reviewed. Data were collected and analyzed using SPSS 25 software. Results A total of 620 patients presented to the hepatobiliary unit for Fibroscan, of which 419 (67.5%) were males. The mean age was 47.8 ± 13.4 (range 18–84). 362(58.3%) had NAFLD, 89 (14.3%) had Hepatitis-B, 69 (11.1%) had Hepatitis-C, 48 (7.7%) had ALD, 20 (3.3%) had DILI, and 13 (2.9%) had autoimmune hepatitis. 190 (30.6%) were overweight (BMI over 25), 128 (20.6%) had diabetes. Liver stiffness corresponding to the diagnosis of F4 liver fibrosis stage on Fibroscan was mostly reported in 6 (46.5%) autoimmune hepatitis, 101 (27.9%) NAFLD, and 18 (26.1%) HCV patients. 141 (45.5%) patients who had one or more metabolic risk factors suffered from severe stage steatosis compared with 78 (28.9%) who had not any risk factors with P -value 0.04. Conclusions Based on our sample , NAFLD is emerging as a predominant etiology of CLD, followed by, HBV, and HCV. This is the first study that reports CLD status in Lebanon, further studies that describe the prevalence and incidence of the disease at a larger scale are needed.

Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter for the Diagnosis of Liver Steatosis and Fibrosis in Patients with Nonalcoholic Fatty Liver Disease

“…In our study, a high percentage of patients (94.5%) were diagnosed with hepatic steatosis (CAP ≥237 dB/m). Among them, 16.6% had S1, 24.9% had S2, and 53% had S3, proportions similar to those reported in another recently published study [30]. Furthermore, in our group, the patients diagnosed with steatosis by CAP were older, more likely to associate hypertension and T2DM, with higher BMI, LSM, FIB-4 index, and NFS values than those without steatosis.…”

Metformin-Associated Lactic Acidosis in a Diabetic Patient with Normal Kidney Function and Occult Cirrhosis

“…Moreover, the diagnosis of alcohol-related liver disease is usually delayed as showed by Subhani et al in a recent paper from the UK where 47% of deaths secondary to alcohol-related liver disease received their first diagnosis in emergency hospital admissions [ 13 ]. In Lebanon, a single-center study in 2020 showed that alcohol-related liver disease represented 7.7% of all causes of chronic liver disease [ 14 ]. Liver disease could contribute to the accumulation of certain drugs and toxins.…”

Diagnostic value of MMP-1 in chronic liver diseases

“…The etiological spectrum of CLDs vary depending on age, research site, illness frequency, availability of diagnostic tools, physician experience and referral pattern [21].…”