Vol. 11 Issue 1 January - March / 2013
Published on website | Date : 2016-04-03 11:41:17
THE VALUES OF HYALURONIC ACID AND AS A MARKER OF CIRRHOSIS IN CHILDREN WITH CHRONIC LIVER DISEASES
Nadia N Hassan, Firyal H Al-Obaidi, Hala S Arif
Background: Hyaluronic acid (HA) is removed by the liver via sinusoidal cell adhesion molecules. This is impeded in fibrosis, leading to a rise in serum HA. As a noninvasive marker of fibrosis, HA may obviate the need for liver biopsy.
Objective:To evaluate HA as a marker of hepatic fibrosis in unselected children undergoing liver biopsy or ultrasound.
Methods: Fifty children aged 2-156 months diagnosed to have different types of chronic liver diseases (CLDs) and thirty healthy children aged 2-156 months were studied as controls were evaluated at the Teaching Hospital and Gastroenterology and Hepatology Center, Medical City, Baghdad, Iraq. The degree of severity of liver infection was assessed by liver biopsy or ultrasound. HA levels were measured using an ELISA.
Results:The mean of HA level was 0.61± 0.32 ng/ml in the control group, 3.05± 1.11 ng/ml in patients with significant fibrosis and 1.18±0.86 ng/ml in patients with chronic liver diseases without significant fibrosis. Significant fibrosis was found in 31 out of 50 children with chronic liver disease, 20 of them were classified (METAVIR score) as cirrhotic liver. Seven out of 18 biopsies value of stage 4. Thirteen out of 32 ultrasounds described as having a coarsely textured liver. The sensitivity and specificity of estimated HA values in the diagnosis of liver cirrhosis were 87.1% and 94.74%, respectively.
Conclusion:HA is a valid noninvasive predictor of histological fibrosis in children with CLD. It complements the thorough investigations of a child with CLD; however, it cannot at present replace histological examination to identify liver fibrosis. Further evaluation of HA is needed to ascertain the use of serial measurements in the targeted patient groups.
Key word: Hyaluronic acid, chronic liver disease, liver fibrosis.
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