Introduction: FibroScan, a non-invasive tool for measuring liver stiffness (LS), is not specific to liver fibrosis. Other extra-hepatic conditions may modify the LS value.
Objectives: Our aim was to examine whether amyloid deposition in the liver may modify LS.
Methods: LS was measured prospectively in 41 patients with systemic AL amyloidosis (AL) in the French AL Reference Center, comprising: 5 patients with liver involvement (LI) and no cardiac involvement (CI), 11 with CI and no LI, 12 with both LI and CI and 13 with neither (2005 consensus criteria); 26 negative controls, 50 patients infected with Hepatitis C virus (HCV)-infected and 18 AL-free patients with right-sided heart disease ('cardiac controls') were also examined.
Results: Median LS was significantly higher in patients with AL with liver involvement [27.4 (10.3-75) kPa] than in negative controls [4.8 (2.8-11.9) kPa] (p < 0.0001), and patients infected with HCV [(6.8 (2.9-69.1) kPa] (p = 0.001), and tended to be higher than in the 'cardiac controls' [11 (4.1-75) kPa] (p = 0.08). A cut-off value of 17.3 kPa, prioritising specificity, is proposed for routine diagnosis of significant AL liver infiltration.
Conclusion: LS > 17.3 kPa is suggestive of AL hepatic disease in patients with non-fibrotic liver changes, and may have diagnostic value in patients with known AL.