Liver stiffness is able to differentiate hepatosplenic Schistosomiasis mansoni from liver cirrhosis and spleen stiffness may be a predictor of variceal bleeding in hepatosplenic schistosomiasis

Abstract Background Ultrasonography is limited for differentiating portal hypertension due to liver cirrhosis from that secondary to hepatosplenic schistosomiasis (HSS). We aimed to investigate the role of transient elastography (TE) in differentiating HSS mansoni from cirrhosis and the factors asso...

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Published in:	Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 116; no. 1; pp. 26 - 33
Main Authors:	Silva, Catherine F, Nardelli, Mateus J, Barbosa, Fernanda A, Galizzi, Humberto O, Cal, Tereza C M F, Ferrari, Teresa C A, Faria, Luciana C, Couto, Claudia A
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 19-01-2022
Subjects:	Cross-Sectional Studies Esophageal and Gastric Varices - diagnostic imaging Esophageal and Gastric Varices - etiology Fascioliasis Gastrointestinal Hemorrhage - diagnostic imaging Gastrointestinal Hemorrhage - etiology Humans Liver Cirrhosis - diagnosis Liver Cirrhosis - diagnostic imaging Schistosomiasis - complications Schistosomiasis mansoni - diagnosis Schistosomiasis mansoni - diagnostic imaging Spleen - diagnostic imaging Thrombosis - complications transient elastography steatohepatitis schistosomiasis hepatosplenic schistosomiasis liver cirrhosis Fibroscan
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Summary:	Abstract Background Ultrasonography is limited for differentiating portal hypertension due to liver cirrhosis from that secondary to hepatosplenic schistosomiasis (HSS). We aimed to investigate the role of transient elastography (TE) in differentiating HSS mansoni from cirrhosis and the factors associated with liver and spleen stiffness (LS and SS) in HSS. Method A cross-sectional study was conducted including patients with HSS mansoni (n=29) and liver cirrhosis due to non-alcoholic steatohepatitis (n=23). All patients underwent TE and those with HSS were assessed by the Niamey protocol. Results HSS subjects presented lower median LS (9.6 vs 21.3 Kpa, p<0.001) and liver controlled attenuation parameter (229 vs 274 dB/m, p=0.010) than cirrhosis subjects, in addition to higher SS (73.5 vs 42.2 Kpa, p=0.002). The area under the receiver operating characteristic curve for detecting cirrhosis by LS was 0.947 (95% CI 0.89 to 1.00, p<0.001), with an optimal cut-off of 11.75 Kpa. In HSS subjects, higher SS was associated with the presence of the following: diabetes mellitus (p=0.036), metabolic syndrome (p=0.043), esophageal varices (p=0.001), portal vein thrombosis (p=0.047) and previous variceal bleeding (p=0.011). In HSS patients without portal vein thrombosis, variceal bleeding was associated with higher SS (p=0.018). Niamey categories were not associated with LS (p=0.676) or SS (p=0.504). Conclusion TE can play a role in differentiating HSS from cirrhosis, especially by LS. SS may be further investigated for predicting complications in HSS.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0035-9203 1878-3503
DOI:	10.1093/trstmh/trab041