Liver stiffness assessment by transient elastography suggests high prevalence of liver involvement in common variable immunodeficiency.
Adult
Common Variable Immunodeficiency
/ complications
Cross-Sectional Studies
Elasticity Imaging Techniques
Female
Humans
Italy
Liver
/ diagnostic imaging
Liver Cirrhosis
/ diagnostic imaging
Liver Function Tests
Male
Middle Aged
Prevalence
ROC Curve
Retrospective Studies
Spleen
/ diagnostic imaging
Antibody deficiency
Fibroscan
Primary immunodeficiency
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
29
01
2019
revised:
06
05
2019
accepted:
09
05
2019
pubmed:
4
6
2019
medline:
5
6
2020
entrez:
4
6
2019
Statut:
ppublish
Résumé
Up to 50% of patients with common variable immunodeficiency (CVID) present persistently increased serum levels of liver enzymes and/or mild hepatomegaly. Ultrasound-based transient elastography (TE) is largely used for early detection of the progression of chronic liver diseases, but has never been employed in CVID. We performed a cross-sectional study to evaluate TE values in a cohort of adult CVID-patients. Full blood count, liver function test, liver and spleen sonogram and ultrasound-based TE were performed in 77 adult CVID patients. Demographic and clinical data were retrospectively collected from medical files. 33.8% (26/77) patients presented increased TE values ranging from moderate fibrosis to cirrhosis. TE values were positively correlated with ALP, γGT, spleen longitudinal diameter and peripheral blood counts (no significant correlation with BMI, AST, ALT, total proteins, albumin, bilirubin and hemoglobin). Moreover, liver stiffness was higher in patients with the clinical phenotypes polyclonal lymphoproliferation and enteropathy, and patients with both these complications had an increased risk (OR: 7.14) of presenting pathologic TE values compared with those without anyone of these. Transient elastography is a useful tool to be used alongside clinical and laboratory data to assess liver involvement in CVID.
Sections du résumé
BACKGROUND
Up to 50% of patients with common variable immunodeficiency (CVID) present persistently increased serum levels of liver enzymes and/or mild hepatomegaly. Ultrasound-based transient elastography (TE) is largely used for early detection of the progression of chronic liver diseases, but has never been employed in CVID. We performed a cross-sectional study to evaluate TE values in a cohort of adult CVID-patients.
METHODS
Full blood count, liver function test, liver and spleen sonogram and ultrasound-based TE were performed in 77 adult CVID patients. Demographic and clinical data were retrospectively collected from medical files.
RESULTS
33.8% (26/77) patients presented increased TE values ranging from moderate fibrosis to cirrhosis. TE values were positively correlated with ALP, γGT, spleen longitudinal diameter and peripheral blood counts (no significant correlation with BMI, AST, ALT, total proteins, albumin, bilirubin and hemoglobin). Moreover, liver stiffness was higher in patients with the clinical phenotypes polyclonal lymphoproliferation and enteropathy, and patients with both these complications had an increased risk (OR: 7.14) of presenting pathologic TE values compared with those without anyone of these.
CONCLUSIONS
Transient elastography is a useful tool to be used alongside clinical and laboratory data to assess liver involvement in CVID.
Identifiants
pubmed: 31155490
pii: S1590-8658(19)30595-X
doi: 10.1016/j.dld.2019.05.016
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1599-1603Informations de copyright
Copyright © 2019. Published by Elsevier Ltd.