Non-invasive assessment of fibrosis and steatosis in pediatric non-alcoholic fatty liver disease - 12/01/22
, Calvin Q. Pan b, c, ⁎ Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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Highlights |
- | Pediatric Non-Alcoholic Fatty Liver Disease serum marker tests and abdominal sonogram either show poor results, lack large scale validation, or need further development. |
- | Magnetic Resonance Elastography has higher relative accuracy compared to the other assessment techniques assessed by this review, but high cost and scarcity have limited its use. |
- | Liver biopsy remains the gold standard for pediatric Non-Alcoholic Fatty Liver Disease assessment. |
- | Current evidence supports the use of Fibroscan for the evaluation of Non-Alcoholic Fatty Liver Disease in the pediatric population. |
Abstract |
Background and Aims |
Non-Alcoholic Fatty Liver Disease (NAFLD) has become one of the most common causes of chronic liver disease in the pediatric population. Recent advances have been made in developing non-invasive measures for NAFLD assessment. This review presents an analysis of these latest developments and also proposes an algorithm for screening pediatric patients at risk for NAFLD.
Methods |
A systematic literature search on PUBMED and EMBASE was conducted. Guidelines for clinical care of pediatric NAFLD were also reviewed.
Results |
In imaging tests, transient elastography (TE) combined with controlled attenuation parameter (CAP) is a promising, relatively low-cost method offering an intermediate level of accuracy on accessing patient's fibrosis and steatosis in a singular package. Liver biopsy remains the gold standard for diagnosis and/or evaluation of NAFLD, but with our proposed algorithm on utilizing non-invasive testing, the number of liver biopsies required could decrease. The current evidence supports the implementation of TE and CAP in an evaluation algorithm for pediatric NAFLD.
Conclusions |
Current data support the use of TE and CAP as a first-line tool in the diagnosis and evaluation of adolescent NAFLD, to better stratify high-risk patients and cut down on the number of liver biopsies needed.
El texto completo de este artículo está disponible en PDF.Keywords : Non-alcoholic fatty liver disease, Pediatric, Non-invasive, Fibroscan, Shear wave elastography, Magnetic Resonance Elastography
Abbreviations : AASLD, ALT, APRI, AST, AUROC, CAP, CT, EASL, ESPGHAN, FIB-4, HCC, HFF, LSM, MRE, MRI, MRS, NAFLD, NASH, NASPGHAN, NFS, NPV, PNFS, PDFF, PNFI, PPV, SSWE, SWE, TE
Esquema
| Conflict of Interest Disclosures: Mr. Bryan Chen has nothing to disclose. Dr. Calvin Q Pan is a speaker for Intercept and Gilead Sciences, Inc. |
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| Financial Disclosures: Neither author received outside financial support nor grant support for the execution of this study. |
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| Acknowledgements: None |
Vol 46 - N° 1
Artículo 101755- janvier 2022 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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