Liver stiffness in AL amyloidosis: interest in diagnosis and prognosis.

Authors

Paul Carrier, Véronique Loustaud-Ratti, Jean-François Cadranel, Céline Rigaud, Bienvenue Randrianarivo, David Lavergne, Laurent Alric, Aurore Baron, Eric Nguyen Khac, Arnaud Pauwels, Louis Bettan, Xavier Causse, Honoré Zougmoure, Abdelali El Kharrazi, Marilyne Debette-Gratien, Anne Cypierre, Murielle Roussel, Arnaud Jaccard

Published in

Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis. Pages 1-10. Sep 06, 2026. Epub Sep 06, 2026.

Abstract

Liver is frequently involved in AL amyloidosis. Diagnosis usually relies on hepatomegaly and elevated alkaline phosphatase levels. Liver stiffness (LS) at diagnosis and, overall, its follow-up remains to be further explored.
We assessed LS at diagnosis in a retrospective multicenter cohort. Patients were classified as having liver involvement only (group 1), heart involvement only (group 2), both (group 3), or neither (group 4). In a prospective monocentric cohort, we evaluated changes in LS over time.
In the retrospective cohort of 56 patients, median LS values were 75 kPa in group 1 (n = 14), 11.6 kPa in group 2 (n = 17), 28.8 kPa in group 3 (n = 13), and 6.4 kPa in group 4 (n = 12). The ROC curve in patients with liver involvement identified an optimal cutoff of 13.6 kPa, with 92% sensitivity and 71% specificity. In the prospective cohort of 19 treated patients, median LS decreased with 91% reduction, 26% reduction, 79% reduction and 19% reduction respectively in groups 1, 2, 3 and 4.
LS is useful for diagnosing hepatic involvement in amyloidosis. A threshold of 13.6 kPa, in the absence of other etiologies, could be prosposed as diagnostic criteria. A decrease in LS greater than 50% can be a marker of hepatic recovery. Clinically and prognostically significant cutoffs still need to be confirmed in future, larger-scale studies.

PMID:
42702009
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.

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