Document Type

Journal Article

Publication Title

Mayo Clinic Proceedings

Volume

97

Issue

9

First Page

1649

Last Page

1655

PubMed ID

35422339

Publisher

Elsevier

School

School of Medical and Health Sciences

RAS ID

44281

Funders

National Health and Medical Research Council

Grant Number

NHMRC Numbers : APP1048740, APP1061332

Grant Link

http://purl.org/au-research/grants/nhmrc/1048740 http://purl.org/au-research/grants/nhmrc/1061332

Comments

This is an Authors Accepted Manuscript version of an article published by ELSEVIER in Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2022.02.017

Andersson, L., Powell, L. W., Ramm, L. E., Ramm, G. A., & Olynyk, J. K. (2022). Arthritis prediction of advanced hepatic fibrosis in HFE hemochromatosis. Mayo Clinic Proceedings, 97(9), 1649-1655. https://doi.org/10.1016/j.mayocp.2022.02.017

Abstract

Objective: To evaluate whether arthritis predicts the likelihood of advanced hepatic fibrosis in HFE hemochromatosis. Patients and Methods: We conducted a retrospective, cross-sectional analysis of 112 well-characterized patients with HFE hemochromatosis and liver biopsy–validated fibrosis staging recruited between January 1, 1983, and December 31, 2013. Complete clinical, biochemical, hematologic, and noninvasive serum biochemical indices (aspartate aminotransferase to platelet ratio index [APRI] and fibrosis 4 index [FIB4]) were available. Scheuer fibrosis stages 3 and 4, APRI greater than 0.44, or FIB4 greater than 1.1 were used to define advanced hepatic fibrosis. Comparisons between groups were performed using categorical analysis, unpaired or paired t test. Results: Male (n = 76) and female (n=36) patients were similar in age. Nineteen patients had advanced hepatic fibrosis, and 47 had hemochromatosis arthritis. Arthritis was significantly associated with the presence of advanced hepatic fibrosis as determined by liver biopsy (sensitivity, 84 %, [95 % CI, 62 % to 95 %]; negative predictive value, 95 % [95 % CI, 87 % to 99 %]; relative risk, 7.4 [95 % CI, 2.5 to 23]; P <. 001), APRI (sensitivity, 75 % [95 % CI, 55 % to 88 %]; negative predictive value, 91 % [95 % CI, 81 % to 96 %]; relative risk, 4.5 [95 % CI, 2.0 to 10.2]; P <. 001), or FIB4 (sensitivity, 61 % [95 % CI, 41 % to 78 %]; negative predictive value, 67 % [95 % CI, 68 % to 90 %]; relative risk, 2.2 [95 % CI, 1.1 to 4.6]; P =. 03). Mean cell volume values were significantly higher pretreatment in patients with F3 - 4 fibrosis (96.7 ± 1.1 fL) compared with F0 - 2 fibrosis (93.4 ± 0.5 fL; P =. 004) and declined following treatment (F3 - 4, 93.2± 0.9 fL, P =. 01; F0 - 2, 91.7 ± 0.6 fL, P =. 01). Conclusion: Advanced hepatic fibrosis is strongly associated with arthritis in HFE hemochromatosis. The absence of arthritis predicts a low likelihood of advanced hepatic fibrosis, supporting its use as a clinical marker for advanced hepatic fibrosis in HFE hemochromatosis.

DOI

10.1016/j.mayocp.2022.02.017

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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