Leberbiopt unnötig bei 66% der Fälle und Ferritin >1000

[pdesterke]

Source: http://www.medscape.com/viewarticle/588596

Blood Test Helps Spot Cirrhosis in Hereditary Hemochromatosis
By David Douglas
Abstract

NEW YORK (Reuters Health) Feb 23 - Measuring serum hyaluronic acid along with serum ferritin helps diagnose cirrhosis and reduce the need for biopsy in patients with hereditary hemochromatosis, Australian researchers report in the February issue of Hepatology.

"The development of non-invasive markers of liver damage are an important advance in the diagnosis and management of patients with liver disease," lead investigator Dr. Darrell H. G. Crawford of the University of Queensland, Greenslopes, told Reuters Health.

"In this study," he added, "we showed that measurement of hyaluronic acid and ferritin concentrations by a relatively simple blood test allowed us to accurately predict which patients with hereditary hemochromatosis had cirrhosis."

The authors studied 55 patients with c282y hereditary hemochromatosis.

No patient with a serum ferritin level below 1000 ug/L had cirrhosis. Of those with higher serum ferritin levels, 40% were cirrhotic.

When cirrhosis was diagnosed on the basis of low platelet count, elevated aspartate aminotransferase level, and serum ferritin above 1000 ug/L, 30% of affected patients were missed, according to the article.

Using the combination of serum ferritin level above 1000 ug/L and hyaluronic acid level above 46.5 ng/mL improved both specificity and sensitivity for cirrhosis to 100%.

"This is an important observation," concluded Dr. Crawford, "and, if confirmed in other studies, may reduce the need for liver biopsy in this condition."

Hepatology 2009;49:418-425.

Full text auf: http://hemochromatosis.co.uk/0asdf/0200 ... -brisb.pdf