Association of clinical manifestations of Opisthorchis felineus invasion with elevated FIB-4 index levels

Introduction. Clinical manifestations of Opisthorchis felineus (O. felineus) invasion are characterized by pronounced polymorphism and can include lesions of various organs and systems, including the development of hepatitis and cirrhosis of the liver. Aim. To study the frequency of clinical manifestations of O. felineus invasion in patients with opisthorchiasis with a FIB-4 index value of more than 1.45.

Materials and methods. A total of 360 patients with O. felineus invasion (158 men and 202 women, average age 40.6 years) aged 18 to 70 years were examined. Clinical examination of patients was carried out using standard questionnaires that allowed assessing the frequency and intensity of symptoms. O. felineus invasion was diagnosed using duodenal bile microscopy and coproovoscopy. All patients underwent esophagogastroduodenoscopy, abdominal ultrasound, complete blood count and biochemical blood assay. The FIB-4 index was calculated, the value of which was more than 1.45 indicated a high probability of liver fibrosis.

Results. In patients with opisthorchiasis with FIB-4 index more than 1.45, weekly pain in the right hypochondrium, obesity, erosions of the stomach and duodenum, hepatomegaly, liver steatosis, signs of cholecystitis by ultrasound, biliary sludge, polyps in the gallbladder, increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the blood were more often registered compared to individuals with FIB-4 index less than 1.45. Hepatomegaly was associated with weekly pain in the right hypochondrium, obesity, liver steatosis, signs of cholecystitis, the presence of biliary sludge, cholecystectomy, neutropenia, elevated ALT and AST levels, FIB-4 index above 1.45.

Conclusions. The FIB-4 index is a useful diagnostic tool, since it is easily calculated from the indicators of routine blood tests. Patients with elevated FIB-4 values and hepatomegaly have more pronounced intensity of clinical symptoms of the disease and require active diagnostic and therapeutic measures to prevent complications.

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