Vibration Controlled Transient Elastography (Fibroscan®) in sickle cell liver disease - could we strike while the liver is hard?

Br J Haematol. 2019 Oct;187(1):117-123. doi: 10.1111/bjh.16047. Epub 2019 Jun 19.

Abstract

Vibration controlled transient elastography (VCTE) is validated for the evaluation of hepatic fibrosis in different liver diseases. Sickle cell liver disease (SCLD) results from a cumulative hepatic injury and its lifelong and progressive nature raises the need for a non-invasive tool for fibrosis evaluation. Fifty patients, aged between 23 and 59 years with sickle cell disease and suspected SCLD underwent a VCTE followed by a liver biopsy. Biopsies were evaluated for various scores of liver disease that were then correlated to VCTE score. 90% of our patients had an Ishak Fibrosis (IF) score between 0-2 (Group A-minimal to no fibrosis) and 10% of the patients had IF score between 3-6 (Group B-advanced fibrosis). The median Transient Elastography (TE) for patients in Groups A and B was 4·8 kilopascals (kPa) and 17·6 kPa, respectively. A positive correlation was shown between TE and IF score, R = 0·0·68 (P = <0·0001); a positive correlation was also shown with Histology Activity Index fibrosis score, R = 0·64 (P = <0·0001). This study emphasises the need for further studies of non-invasive tools and their utility in liver fibrosis evaluation of patients with SCLD.

Keywords: liver biopsy; sickle cell disease; sickle cell hepatopathy; sickle cell liver disease; vibration controlled transient elastography.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Anemia, Sickle Cell / diagnostic imaging*
  • Anemia, Sickle Cell / pathology
  • Biopsy
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Liver / diagnostic imaging*
  • Liver / pathology
  • Liver Diseases / diagnostic imaging*
  • Liver Diseases / pathology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Vibration
  • Young Adult