Será uma refeição ligeira fator de erro na avaliação da dureza hepática por elastografia hepática transitória? Um estudo prospetivo

• Autor(a) principal: Caetano, AC
• Data de Publicação: 2014
• Outros Autores: Lages, J, Gonçalves, B, Soares, JB, Gonçalves, R, Rolanda, C
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.23/851
• topic: Técnicas de Imagem por Elasticidade; Fígado; Jejum

Introduction: Transient Elastography (TE) is a noninvasive method widely used to evaluate hepatic fibrosis in patients with liver disease, especially in chronic hepatitis C. It has excellent accuracy in identifying patients with advanced fibrosis or cirrhosis. However, some factors can interfere with liver stiffness (LS) measurement. The food intake may be one of those confounding factors and there are no defined conditions under which the examination should be performed. Objectives: To evaluate the influence of food intake in LS and its potential interference with the clinical management of patients with chronic hepatitis B and chronic hepatitis C. Patients & Methods: Observational prospective study in which TE was performed in two physiological conditions --- fasting and after (30-60 minutes) a standard meal --- in a sample of 42 patients with chronic hepatitis B, 26 chronic hepatitis C and 42 controls. The analysis was complemented by the division into subgroups according to the presumed stage of fibrosis. Results: Despite the LS variation in all groups with food intake, a significant increase was only seen in individuals with chronic hepatitis B without suspected fibrosis (low LS) (p = 0,001). This variation could influence the clinical orientation in 11.8% of cases. Conclusion: In our study, a meal altered LS value in chronic hepatitis B without suspected fibrosis (low LS). As it does not seem to interfere significantly with the clinical management of our patients, we can not, at this point, make any suggestion about the usefulness of performing this exam in the fasting condition.