{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:43:10Z","timestamp":1786977790113,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2403,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,2]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      Diagnosing the presence of cirrhosis is crucial for the management of patients with C282Y hereditary hemochromatosis (HH). HH patients with serum ferritin &gt;1,000 \u03bcg\/L are at risk of cirrhosis; however, the majority of these patients do not have cirrhosis. Noninvasive markers of hepatic fibrosis may assist in determining which patients with a serum ferritin &gt;1,000 \u03bcg\/L have cirrhosis and require liver biopsy. This study evaluated the utility of current diagnostic algorithms for detecting cirrhosis, including serum ferritin concentration, platelet counts, and aspartate aminotransferase (AST) levels, in combination with serum markers of fibrosis, hyaluronic acid and collagen type IV (CLIV), in predicting cirrhosis in HH patients. Stage of fibrosis, serum hyaluronic acid and CLIV levels, were measured in 56 patients with HH. No patient with a serum ferritin &lt;1,000 \u03bcg\/L had cirrhosis, but only 40% of patients with serum ferritin &gt;1,000 \u03bcg\/L were cirrhotic. A combination of platelet count (&lt;200 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L), elevated AST, and serum ferritin &gt;1,000 \u03bcg\/L did not detect 30% of cirrhotic subjects. Serum hyaluronic acid was increased in HH compared with controls (42.0 \u00b1 9.8 ng\/mL versus 19.3 \u00b1 1.8 ng\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02). A hyaluronic acid concentration &gt;46.5 ng\/mL was 100% sensitive and 100% specific in identifying patients with cirrhosis. In patients with serum ferritin &gt;1,000 \u03bcg\/L, hyaluronic acid levels were significantly elevated in patients with cirrhosis versus those without cirrhosis (137 \u00b1 34.4 ng\/mL versus 18.6 \u00b1 1.5 ng\/mL, respectively;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006). CLIV &gt;113 ng\/mL was 100% sensitive but only 56% specific for cirrhosis (area under the curve = 0.78;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01).\n                      <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                      In HH, the measurement of hyaluronic acid in patients with serum ferritin &gt;1,000 \u03bcg\/L is a noninvasive, accurate, and cost-effective method for the diagnosis of cirrhosis. (Hepatology 2009;49:418\u2013425.)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.22650","type":"journal-article","created":{"date-parts":[[2008,9,22]],"date-time":"2008-09-22T14:27:23Z","timestamp":1222093643000},"page":"418-425","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":42,"title":["Serum hyaluronic acid with serum ferritin accurately predicts cirrhosis and reduces the need for liver biopsy in C282Y hemochromatosis #"],"prefix":"10.1097","volume":"49","author":[{"given":"Darrell H. 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