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Transient elastography and aspartate aminotransferase to platelet ratio predict liver injury in paediatric intestinal failure.
- Source :
-
Liver International . Mar2016, Vol. 36 Issue 3, p361-369. 9p. - Publication Year :
- 2016
-
Abstract
- Background & Aims We aimed to evaluate the value of AST to platelet ratio ( APRI) and transient elastography ( TE) as predictors of liver histopathology in children with intestinal failure ( IF). Methods Altogether 93 liver biopsies from 57 children with parenteral nutrition ( PN) duration ≥3 months were analysed. APRI measurement and TE ( n = 46) were performed at the time of biopsy. Results IF was caused by short bowel syndrome in 75% of patients. At the time of liver biopsy, PN dependent patients ( n = 42) were younger with longer PN duration compared to those weaned off PN ( n = 51) (2.2 vs. 7.6 years, P < 0.001; 26 vs. 10.5 months, P = 0.043). Elevated transaminase or bilirubin levels were found in 51%, splenomegaly in 26%, and oesophageal varices in 3.5%. Histological fibrosis was present in 61% (Metavir stage F1; 27%, F2; 26%, F3-4; 9%), cholestasis in 25% and steatosis in 22% of biopsy specimens. TE was superior to APRI in prediction of any liver histopathology (fibrosis, cholestasis or steatosis) with areas under the receiving operating curve ( AUROC) of 0.86 (95% CI 0.74-0.97) and 0.67 (95% CI 0.58-0.78) respectively. For prediction of ≥F1 and ≥F2 fibrosis, AUROC values for TE were 0.78 (95% CI 0.64-0.93) and 0.73 (95% CI 0.59-0.88), whereas APRI did not correlate with fibrosis stages. For detection of histological cholestasis, the AUROC for APRI was 0.77 (95% CI 0.64-0.89). Conclusions Both TE and APRI are promising noninvasive methods for monitoring the development of IF-related liver histopathology. TE values reflected the degree of fibrosis better while APRI detected histological cholestasis more accurately. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14783223
- Volume :
- 36
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Liver International
- Publication Type :
- Academic Journal
- Accession number :
- 112968322
- Full Text :
- https://doi.org/10.1111/liv.12887