Dynamic changes in liver stiffness during the course of acute hepatitis A

Yeon Seok Seo, Kwang Gyun Lee, Eun Suk Jung, Hyonggin An, Sanghoon Park, Bora Keum, Hyung Joon Yim, Yoon Tae Jeen, Hoon Jai Chun, Chang Duck Kim, Ho Sang Ryu, Soon Ho Um

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Objective. Several recent studies have suggested that hepatic necroinflammation can alter the results of liver stiffness measurements (LSMs) obtained using the FibroScan device. However, the precise relationship between acute hepatic inflammation and LSMs remains unclear. The aim of this study was therefore to evaluate the dynamic changes in LSMs during the course of acute hepatic inflammation. Material and methods. Thirty-one patients with acute hepatitis A (AHA) were enrolled in this study (mean ± SD age 29 ± 7 years; 32.3% male). Only AHA patients who visited our hospital before their alanine aminotransferase (ALT) levels peaked were included. The day when AHA-associated symptoms began was considered as Day 0. Serum levels of ALT and bilirubin (BIL), and the international normalized ratio (INR) were measured every 2 days, as were LSMs, until the peak levels of all parameters were identified. Subsequently, these parameters were measured every 12 weeks until they had normalized. Results. Peak serum levels of ALT and BIL, the INR, and LSMs were 3723 ± 1513 IU/l, 5.8 ± 2.4 mg/dl, 1.3 ± 0.3, and 11.9 ± 5.7 kPa, respectively. The time taken for LSMs to peak from Day 0 (8 ± 2 days) differed significantly from that for ALT (5 ± 1 days), BIL (10 ± 4 days), and INR (5 ± 1 days). LSMs had normalized (≤ 5.5 kPa) in all patients at 34 ± 17 days after Day 0. ALT level and the INR were significantly associated with peak LSMs and BIL level and the INR with the time taken for normalization of LSMs. Conclusions. LSMs changed dynamically during the course of AHA. The pattern of change appears to be related to the severity of hepatic necroinflammation.

Original languageEnglish
Pages (from-to)449-456
Number of pages8
JournalScandinavian Journal of Gastroenterology
Issue number4
Publication statusPublished - 2010 Apr 14
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by a Korea University Grant and a grant from the Ministry for Health, Welfare and Family Affairs of South Korea (No. A050021).


  • Elastography
  • International normalized ratio
  • Necroinflammation
  • Overestimation
  • Stiffness

ASJC Scopus subject areas

  • Gastroenterology


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