Fibroscan as a Non-invasive Tool for Assessment of Hepatic Fibrosis in Children with Beta Thalassemia Major.

Introduction: Fibroscan is a noninvasive tool for measuring liver fibrosis. This study was done to assess liver fibrosis in thalassemic children and to correlate fibroscan findings with supportive markers of increased iron store such as serum ferritin. Methods: This prospective observational study was conducted in children between five and 18 years of age diagnosed with beta thalassemia major who were on regular blood transfusion. The fibroscan findings of liver were correlated with serum ferritin, liver enzymes, and blood transfusion requirements. Results: Among the 34 children who satisfied the inclusion criteria, 22 children (64%) had no fibrosis, 10 (30%) had mild fibrosis, and two (6%) had moderate fibrosis. Higher mean duration of blood transfusion and greater median ferritin levels (3420 vs 1997 µg / L; p-value 0.006) were observed in children with fibrosis. A greater number of transfusions were significantly associated with a greater degree of hepatic fibrosis which was statistically significant (p < 0.05). No association was observed between liver fibrosis and mean age of the study population, gender, and mean age at first transfusion, AST or ALT levels. Spearman's correlation coefficient (rho) measured to estimate the degree and direction of the relationship between degrees of fibrosis with ferritin levels was 0.549, indicating a moderately positive relationship between serum ferritin levels and hepatic fibrosis (p-value - 0.0007). Conclusions: Fibroscan is an affordable, noninvasive, and faster alternative tool to estimate liver fibrosis in children with beta thalassemia major and is directly related to serum ferritin levels and transfusion requirements in children. [ABSTRACT FROM AUTHOR]