Description

Alkhouri et al reported an algorithm for identifying a pediatric patient with nonalcoholic fatty liver disease (NAFLD) with hepatic fibrosis. This relies on 2 noninvasive tests to triage the patient based on risk. The authors are from the Cleveland Clinic, University College London, the University of Florence, Liver Research Unit in Trieste, the University of Milan, Ospedale Maggiore Policlinico in Milan and Bambino Gesu Children’s Hospital in Rome.


 

Patient selection: patient with NAFLD and age <= 18 years

 

Parameters:

(1) pediatric NAFLD fibrosis index (PNFI)

(2) Enhanced Liver Fibrosis test (ELF)

PNFI

ELF Test

Risk Hepatic Fibrosis

Consider Liver Biopsy?

< 3.47

NA

low

no

3.47 to 8.99

< 8.49

low

no

3.47 to 8.99

>= 8.49

high

yes

>= 9.00

NA

high

yes

 

where:

• Performance at these cutoffs requires standardization of the underlying tests.

• Performance will also be affected by patient selection.

 


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