Elevated serum type IV collagen: a sensitive indicator of the presence of cirrhosis in haemochromatosis

Background/Aim: Hereditary haemochromatosis can now be diagnosed by genetic testing, although determining the presence or absence of cirrhosis remains crucial to patient management. While many studies have investigated the ut ility of various serum markers of cirrhosis in chronic liver diseases, few have examined specifically patients with hereditary haemochromatosis, The a im of this study was to assess the utility of serum type IV collagen and se rum laminin in diagnosing hepatic fibrosis and cirrhosis in patients with h ereditary haemochromatosis, Methods: The study group consisted of 42 patients with hereditary haemochro matosis and 19 Caucasian controls, Serum type IV collagen, laminin, matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase (TIMP -1) concentrations were measured by enzyme-linked immunosorbant assay in se rum from patients with haemochromatosis and control subjects, Liver biopsie s from patients with haemochromatosis were graded for fibrosis and correlat ed with serum markers of hepatic fibrosis, Results: Serum type IV collagen concentration was significantly increased i n haemochromatosis patients compared to controls (130+/-79 ng/ml vs 81+/-17 ng/ml, p<0,05) and was significantly correlated with both the grade of his tological fibrosis (r=0.67, p<0,0001) and serum MMP-2 levels (r =0.42, p<0, 05), A serum type IV collagen concentration >115 ng/ml (mean+2 SD of contro ls) was 100% sensitive and 69% specific in detecting severe (grade 3) fibro sis and cirrhosis, The sensitivity results of serum laminin and TIMP-1 were 11% and 56%, respectively. Conclusions: Elevated serum type IV collagen is a sensitive indicator of th e presence of severe fibrosis and cirrhosis in patients with haemochromatos is. Useful markers of hepatic fibrosis in other chronic liver diseases may not be applicable to haemochromatosis.