Morphological and ultrasound features of liver fibrosis in children with autoimmune hepatitis

Authors

  • V. S. Berezenko Bogomolets National Medical University, Kyiv, Ukraine,
  • T. D. Zadorozhna SI “Institute of Pediatrics, Obstetrics and Gynaecology named after Academician O.M. Lukianova of NAMS of Ukraine”, Kyiv,
  • Kh. Z. Mykhailiuk Bogomolets National Medical University, Kyiv, Ukraine,
  • B. A. Tarasiuk SI “Institute of Nuclear Medicine and Diagnostic Radiology of NAMS of Ukraine”, Kyiv,
  • V. F. Korobko SI “Institute of Nuclear Medicine and Diagnostic Radiology of NAMS of Ukraine”, Kyiv,
  • S. M. Kelykhevych SI “Institute of Pediatrics, Obstetrics and Gynaecology named after Academician O.M. Lukianova of NAMS of Ukraine”, Kyiv,

DOI:

https://doi.org/10.14739/2310-1237.2018.3.151815

Keywords:

autoimmune hepatitis, children, fibrosis, elastography

Abstract


Aim. To study the ultrasound peculiarities of the liver parenchyma stiffness in children with autoimmune hepatitis by shear wave elastography comparing with the results of liver biopsy morphological investigation.
Materials and methods. 40 children with autoimmune hepatitis were examined during the period of 2015–2018. All children were provided with a complex of laboratory tests according to the protocol, shear wave elastography of the liver and a puncture biopsy of the liver. The disease activity was ranged with the histological index of activity (IHA) according to Knodell
by the results of a morphological study of liver biopsy and biochemical parameters (alanine aminotransferase, total bilirubin,
gamma globulin, immunoglobulin G). The stage of the disease was estimated by the METAVIR histological index (HIS) and
semi-quantitative elastography of the parenchyma shift wave. A comparison of the relationship between the histological activity
of hepatitis and the parameters of the liver stiffness has been made. The changes in 23 children with hypertension were
investigated in dynamics of liver stiffness (after 6 and 12 months of treatment).
Result. A progressive fibrosis was diagnosed in 72.5 % (n = 29) (METAVIR F2) (χ2 = 16.2; P < 0.001 between the group of
children with F1-2 and F3-4 METAVIR). The ROC analysis showed that, the optimal “cut-off point” for the diagnosis of F3 METAVIR fibrosis was the stiffness index of 9.4 kPa, and for F4 METAVIR – 13.0 kPa. Hepatitis activity influenced the stiffness of the liver parenchyma – with a decrease in the activity of the inflammatory process decreased and the rigidity of the liver
parenchyma (P > 0.05). 
Conclusions. In 50 % of children with autoimmune hepatitis, the stage of fibrosis, which was determined by the method of elastography before treatment, corresponded to the data of the morphological study of liver biopsy. The activity of hepatitis affects the liver parenchyma stiffness, with the decrease of inflammatory process activity this index also decreases. The conducted research showed that in the process of treatment (anti-fibrotic and immunosuppressive therapy), after 6 and 12 months, the parameters of liver parenchyma severity decrease significantly (P < 0.05).

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1.
Berezenko VS, Zadorozhna TD, Mykhailiuk KZ, Tarasiuk BA, Korobko VF, Kelykhevych SM. Morphological and ultrasound features of liver fibrosis in children with autoimmune hepatitis. Pathologia [Internet]. 2018Dec.19 [cited 2024Apr.16];(3). Available from: http://pat.zsmu.edu.ua/article/view/151815

Issue

No. 3 (2018)

Section

Original research

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