Murat Bektaş, Bilger Çavuş, Besim Fazıl Ağargün, İbrahim Volkan Şenkal, Nevzat Koca, Burak İnce, Selma Sarı, Ahmet Burak Dirim, Metban Güzel Mastanzade, Gizem Dağcı, Pelin Karaca Özer, Mehmet Aydoğan, Melek Büyük, Yasemin Yalçınkaya, Bahar Artım-Esen, Murat İnanç, Mine Güllüoğlu, Halil Yazıcı, Sevgi Kalayoğlu Beşışık, Selman Fatih Beşışık, Ahmet Gül
{"title":"AA淀粉样变性患者肝脏和移植肾的瞬时弹性测量：一项横断面比较研究。","authors":"Murat Bektaş, Bilger Çavuş, Besim Fazıl Ağargün, İbrahim Volkan Şenkal, Nevzat Koca, Burak İnce, Selma Sarı, Ahmet Burak Dirim, Metban Güzel Mastanzade, Gizem Dağcı, Pelin Karaca Özer, Mehmet Aydoğan, Melek Büyük, Yasemin Yalçınkaya, Bahar Artım-Esen, Murat İnanç, Mine Güllüoğlu, Halil Yazıcı, Sevgi Kalayoğlu Beşışık, Selman Fatih Beşışık, Ahmet Gül","doi":"10.1007/s00296-025-05906-3","DOIUrl":null,"url":null,"abstract":"<p><p>To evaluate the utility of elasticity imaging techniques, such as transient elastography (FibroScan), in assessing the liver and transplanted kidney in patients with AA amyloidosis (AA-A). This study was conducted in patients with AA-A, while patients with immunoglobulin light chain amyloidosis (AL-A), Familial Mediterranean Fever (FMF) without amyloidosis, and healthy controls (HC) were included as comparison groups for liver stiffness (LS) measurements. Additionally, kidney stiffness (KS) was measured in renal transplant recipients (RTRs) with transplants due to AA-A or other causes of chronic renal failure. LS evaluations were performed in 65 patients with AA-A, 14 with AL-A, 20 with FMF, and 27 with HC. LS (kPa) was significantly higher [median (IQR)] in patients with AA-A [6.4 (5.4)] and AL-A [9.8 (11)] compared to HC [4.7 (1.7)] (p < 0.001). However, the difference between AL-A and AA-A was not statistically significant. LS values were comparable in FMF-AA patients with [6.8 (6.6)] and without [5.7 (3.6)] liver involvement, and FMF patients without amyloidosis [7.15 (4.6)]. The median KS values were comparable in 19 AA-A and 16 disease controls. However, KS values were significantly higher in patients with recurrent amyloidosis in the transplanted kidney [29.3 (18.9)] compared to those without recurrence [10.9 (7.7)] (p = 0.003). In our study, increased liver stiffness measurements were observed in patients with AA-A, AL-A, and FMF compared to HC. Transient elastography using FibroScan appears to be a promising non-invasive tool for assessing liver involvement in AA-A and may aid in detecting recurrence of amyloidosis in transplanted kidneys. 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This study was conducted in patients with AA-A, while patients with immunoglobulin light chain amyloidosis (AL-A), Familial Mediterranean Fever (FMF) without amyloidosis, and healthy controls (HC) were included as comparison groups for liver stiffness (LS) measurements. Additionally, kidney stiffness (KS) was measured in renal transplant recipients (RTRs) with transplants due to AA-A or other causes of chronic renal failure. LS evaluations were performed in 65 patients with AA-A, 14 with AL-A, 20 with FMF, and 27 with HC. LS (kPa) was significantly higher [median (IQR)] in patients with AA-A [6.4 (5.4)] and AL-A [9.8 (11)] compared to HC [4.7 (1.7)] (p < 0.001). However, the difference between AL-A and AA-A was not statistically significant. LS values were comparable in FMF-AA patients with [6.8 (6.6)] and without [5.7 (3.6)] liver involvement, and FMF patients without amyloidosis [7.15 (4.6)]. The median KS values were comparable in 19 AA-A and 16 disease controls. 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Transient elastography measurements of the liver and transplanted kidney in patients with AA amyloidosis: a cross-sectional comparative study.
To evaluate the utility of elasticity imaging techniques, such as transient elastography (FibroScan), in assessing the liver and transplanted kidney in patients with AA amyloidosis (AA-A). This study was conducted in patients with AA-A, while patients with immunoglobulin light chain amyloidosis (AL-A), Familial Mediterranean Fever (FMF) without amyloidosis, and healthy controls (HC) were included as comparison groups for liver stiffness (LS) measurements. Additionally, kidney stiffness (KS) was measured in renal transplant recipients (RTRs) with transplants due to AA-A or other causes of chronic renal failure. LS evaluations were performed in 65 patients with AA-A, 14 with AL-A, 20 with FMF, and 27 with HC. LS (kPa) was significantly higher [median (IQR)] in patients with AA-A [6.4 (5.4)] and AL-A [9.8 (11)] compared to HC [4.7 (1.7)] (p < 0.001). However, the difference between AL-A and AA-A was not statistically significant. LS values were comparable in FMF-AA patients with [6.8 (6.6)] and without [5.7 (3.6)] liver involvement, and FMF patients without amyloidosis [7.15 (4.6)]. The median KS values were comparable in 19 AA-A and 16 disease controls. However, KS values were significantly higher in patients with recurrent amyloidosis in the transplanted kidney [29.3 (18.9)] compared to those without recurrence [10.9 (7.7)] (p = 0.003). In our study, increased liver stiffness measurements were observed in patients with AA-A, AL-A, and FMF compared to HC. Transient elastography using FibroScan appears to be a promising non-invasive tool for assessing liver involvement in AA-A and may aid in detecting recurrence of amyloidosis in transplanted kidneys. Further studies are needed to validate the utility of FibroScan in evaluating the involvement of the liver and kidneys in patients with AA-A.
期刊介绍：
RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology.
RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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