Subclinical but significant liver fibrosis in patients with ANCA-associated vasculitis

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Abstract

OBJECTIVES: We evaluated the laboratory and radiological data on liver and investigate liver fibrosis induced by hepatic manifestation of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) using the aspartate aminotransferase to platelet ratio index (APRI) and an index of fibrosis (FIB-4) in 136 immunosuppressive drug-naïve patients. METHODS: We retrospectively reviewed the medical records of 136 patients with AAV without chronic liver diseases or autoimmune diseases. We collected the laboratory and imaging results. We assessed liver fibrosis by APRI and FIB-4. The critical cut-offs of APRI and FIB-4 for predicting liver fibrosis are 0.5 and 1.45. The optimal cut-off of five factor score (FFS) at diagnosis for FIB-4 ≥1.45 was extrapolated by the area under the receiver operator characteristic curve. RESULTS: The mean age at diagnosis was 54.6 years and 32.4% of patients were male (69 MPA, 38 GPA and 29 EGPA). The percentage of patients having the normal results of liver function tests was ranging from 86.0% to 95.6%. There were no patients who exhibited the significantly abnormal findings on imaging studies. Nonetheless, twenty-nine patients with AAV (21.3%) exhibited subclinical but significant liver fibrosis at diagnosis based on FIB-4. Patients with FFS ≥1 had a significantly higher risk of having subclinical but significant liver fibrosis (FIB-4 ≥1.45) than those with FFS <1 (RR 12.486). CONCLUSIONS: AAV may increase the results of liver function tests and it may provoke subclinical but significant liver fibrosis at diagnosis. Furthermore, liver fibrosis should be considered in AAV patients having FFS ≥1.

Original languageEnglish
Pages (from-to)26-31
Number of pages6
JournalClinical and experimental rheumatology
Volume37
Issue number2
Publication statusPublished - 2019 Mar 1

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Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Liver Cirrhosis
Vasculitis
Blood Platelets
Antibodies
Liver Function Tests
Transaminases
Antineutrophil Cytoplasmic Antibodies
Liver
Immunosuppressive Agents
Aspartate Aminotransferases
Autoimmune Diseases
Medical Records
Liver Diseases
Fibrosis
Chronic Disease

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

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title = "Subclinical but significant liver fibrosis in patients with ANCA-associated vasculitis",
abstract = "OBJECTIVES: We evaluated the laboratory and radiological data on liver and investigate liver fibrosis induced by hepatic manifestation of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) using the aspartate aminotransferase to platelet ratio index (APRI) and an index of fibrosis (FIB-4) in 136 immunosuppressive drug-na{\"i}ve patients. METHODS: We retrospectively reviewed the medical records of 136 patients with AAV without chronic liver diseases or autoimmune diseases. We collected the laboratory and imaging results. We assessed liver fibrosis by APRI and FIB-4. The critical cut-offs of APRI and FIB-4 for predicting liver fibrosis are 0.5 and 1.45. The optimal cut-off of five factor score (FFS) at diagnosis for FIB-4 ≥1.45 was extrapolated by the area under the receiver operator characteristic curve. RESULTS: The mean age at diagnosis was 54.6 years and 32.4{\%} of patients were male (69 MPA, 38 GPA and 29 EGPA). The percentage of patients having the normal results of liver function tests was ranging from 86.0{\%} to 95.6{\%}. There were no patients who exhibited the significantly abnormal findings on imaging studies. Nonetheless, twenty-nine patients with AAV (21.3{\%}) exhibited subclinical but significant liver fibrosis at diagnosis based on FIB-4. Patients with FFS ≥1 had a significantly higher risk of having subclinical but significant liver fibrosis (FIB-4 ≥1.45) than those with FFS <1 (RR 12.486). CONCLUSIONS: AAV may increase the results of liver function tests and it may provoke subclinical but significant liver fibrosis at diagnosis. Furthermore, liver fibrosis should be considered in AAV patients having FFS ≥1.",
author = "Lee, {Sang Won} and Kim, {Do Young} and Ahn, {Sang Hoon} and Park, {Yong Beom} and Han, {Kwang Hyub} and Park, {Jun Yong}",
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T1 - Subclinical but significant liver fibrosis in patients with ANCA-associated vasculitis

AU - Lee, Sang Won

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Park, Yong Beom

AU - Han, Kwang Hyub

AU - Park, Jun Yong

PY - 2019/3/1

Y1 - 2019/3/1

N2 - OBJECTIVES: We evaluated the laboratory and radiological data on liver and investigate liver fibrosis induced by hepatic manifestation of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) using the aspartate aminotransferase to platelet ratio index (APRI) and an index of fibrosis (FIB-4) in 136 immunosuppressive drug-naïve patients. METHODS: We retrospectively reviewed the medical records of 136 patients with AAV without chronic liver diseases or autoimmune diseases. We collected the laboratory and imaging results. We assessed liver fibrosis by APRI and FIB-4. The critical cut-offs of APRI and FIB-4 for predicting liver fibrosis are 0.5 and 1.45. The optimal cut-off of five factor score (FFS) at diagnosis for FIB-4 ≥1.45 was extrapolated by the area under the receiver operator characteristic curve. RESULTS: The mean age at diagnosis was 54.6 years and 32.4% of patients were male (69 MPA, 38 GPA and 29 EGPA). The percentage of patients having the normal results of liver function tests was ranging from 86.0% to 95.6%. There were no patients who exhibited the significantly abnormal findings on imaging studies. Nonetheless, twenty-nine patients with AAV (21.3%) exhibited subclinical but significant liver fibrosis at diagnosis based on FIB-4. Patients with FFS ≥1 had a significantly higher risk of having subclinical but significant liver fibrosis (FIB-4 ≥1.45) than those with FFS <1 (RR 12.486). CONCLUSIONS: AAV may increase the results of liver function tests and it may provoke subclinical but significant liver fibrosis at diagnosis. Furthermore, liver fibrosis should be considered in AAV patients having FFS ≥1.

AB - OBJECTIVES: We evaluated the laboratory and radiological data on liver and investigate liver fibrosis induced by hepatic manifestation of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) using the aspartate aminotransferase to platelet ratio index (APRI) and an index of fibrosis (FIB-4) in 136 immunosuppressive drug-naïve patients. METHODS: We retrospectively reviewed the medical records of 136 patients with AAV without chronic liver diseases or autoimmune diseases. We collected the laboratory and imaging results. We assessed liver fibrosis by APRI and FIB-4. The critical cut-offs of APRI and FIB-4 for predicting liver fibrosis are 0.5 and 1.45. The optimal cut-off of five factor score (FFS) at diagnosis for FIB-4 ≥1.45 was extrapolated by the area under the receiver operator characteristic curve. RESULTS: The mean age at diagnosis was 54.6 years and 32.4% of patients were male (69 MPA, 38 GPA and 29 EGPA). The percentage of patients having the normal results of liver function tests was ranging from 86.0% to 95.6%. There were no patients who exhibited the significantly abnormal findings on imaging studies. Nonetheless, twenty-nine patients with AAV (21.3%) exhibited subclinical but significant liver fibrosis at diagnosis based on FIB-4. Patients with FFS ≥1 had a significantly higher risk of having subclinical but significant liver fibrosis (FIB-4 ≥1.45) than those with FFS <1 (RR 12.486). CONCLUSIONS: AAV may increase the results of liver function tests and it may provoke subclinical but significant liver fibrosis at diagnosis. Furthermore, liver fibrosis should be considered in AAV patients having FFS ≥1.

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