Advances in diagnosis of chronic liver diseases in pediatric patients

Ružman, Lucija; Mikolašević, Ivana; Dekanić, Kristina Baraba; Milić, Sandra; Palčevski, Goran

doi:10.1007/s12519-018-0197-8

Cited by 9 publications

(4 citation statements)

References 52 publications

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“…However, liver biopsy is restricted being an invasive technique that might result in patient hazards such as pain, bleeding, and biliary system injury, along with variable accessibility, high cost, sampling mistakes, and inaccuracy due to inconsistency of pathologic interpretations [2]. These limitations promote the development of less invasive methods to assess liver fibrosis especially in children [3].…”

Section: Introductionmentioning

confidence: 99%

Comparative study between liver biopsy and non-invasive biomarkers in assessment of hepatic fibrosis in children with chronic liver diseases

Behairy

El-Shimi

Shalan

2021

Egypt Pediatric Association Gaz

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Background Liver biopsy is the gold standard for detecting the degree of liver fibrosis; however, invasiveness constitutes its main limiting factor in clinical application, so we aimed to evaluate the non-invasive biomarker formulas (APRI and FIB-4) and their modified forms by BMI z-score (M-APRI, M-FIB-4, and B-AST) compared to liver biopsy in the assessment of liver fibrosis in children with chronic liver diseases. Two hundred children aged 6.3 ± 3.8 years (98 males, 102 females) with chronic liver diseases underwent liver biopsy. The stage of fibrosis was assessed according to the METAVIR system for all children, and the following non-invasive biomarker formulas were calculated: APRI, modified APRI (M-APRI: BMI z-score × APRI), Fibrosis-4 index (FIB-4), modified FIB-4 (M-FIB-4: BMI z-score × FIB-4), and B-AST (BMI z-score × AST). The best cutoff value was calculated to detect early fibrosis (F1–F2) from advanced liver fibrosis (F3–F4). Results There were positive correlations between all studied non-invasive biomarker models (APRI, FIB-4, M-APRI, M-FIB-4, B-AST) and fibrosis score as an increase in fibrosis score was associated with an increase in mean ± SD of all studied biomarker formulas. The best cutoff values of non-invasive biomarker models in the diagnosis of early fibrosis (F1–F2) were APRI > 0.96, M-APRI > 0.16, FIB-4 > 0.019, M-FIB-4 > 0.005, and B-AST > −8 with an area under the curve above 0.7 each, while the best cutoff values of non-invasive biomarker models (APRI, M-APRI, FIB-4, M-FIB-4, and B-AST) in the diagnosis of advanced liver fibrosis (F3–F4) were >1.96, >2.2, >0.045, and >0.015, >92.1, respectively, with an area under the curve above 0.8 each. Conclusion APRI, M-APRI, FIB-4, M-FIB-4, and B-AST are good non-invasive alternatives to liver biopsy in the detection of liver fibrosis in children with chronic liver diseases of different etiologies especially those that include BMI z-scores in their formulas.

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Section: Introductionmentioning

confidence: 99%

Comparative study between liver biopsy and non-invasive biomarkers in assessment of hepatic fibrosis in children with chronic liver diseases

Behairy

El-Shimi

Shalan

2021

Egypt Pediatric Association Gaz

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“…It necessitates a clinicopathological evaluation that involves a thorough history, examination, and a number of diagnostic tests. Although advancements have been made in the diagnostic field, to detect and categorize liver damage non-invasively, a biopsy of the liver is the gold standard for liver disease diagnostics [6,7].…”

Section: Introductionmentioning

confidence: 99%

Etiology in Children Presented With Chronic Liver Disease in a Tertiary Care Hospital

Sardar¹,

Parkash²,

Merchant³

et al. 2022

Cureus

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“…Chronic liver disease (CLD) represents an important clinical challenge in pediatrics. Metabolic conditions can present in the first years of life and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) is recognized more commonly in older children (1,2) However, nonalcoholic fatty liver disease (NAFLD), a spectrum of hepatic disease involving fatty infiltration of the liver, is emerging as a serious pediatric problem because of the obesity epidemic that is affecting adults as well as children and adolescents (3,4).…”

Section: Introductionmentioning

confidence: 99%

The Changing Epidemiology of Liver Disease Among US Children and Adolescents From 1999 to 2016

Barakat

et al. 2021

Am J Gastroenterol

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INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) and infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) are major causes of liver disease in adults. However, data for children and adolescents are limited. Our study aimed to characterize the prevalence, trend, and risk factors of infection of HBV and HCV and possible NAFLD for this population. METHODS: We analyzed 6,647 children and adolescents (aged 6–21 years) from the 1999–2016 National Health and Nutrition Examination Survey. RESULTS: Among individuals aged 6–21 years, HBV prevalence decreased after 2011, from 0.72% in 1999–2004 and 0.85% in 2005–2010 to 0.27% in 2011–2016 (P < 0.001), whereas HCV prevalence increased to 0.26% in 2011–2016 after an initial decline from 0.15% in 1999–2004 to 0.02% in 2005–2010 (P = 0.01). Possible NAFLD prevalence also increased by approximately 40% in individuals aged 12–21 years, from 8.54% in 1999–2004 to 10.1% in 2005–2010 and then 11.8% in 2011–2016 (P = 0.033), with most possible NAFLD individuals being male, being obese, or having higher glucose, fasting insulin, hemoglobin A1c, homeostatic model assessment of insulin resistance, liver enzymes, lipids, and uric acid (all P < 0.01). On multivariate logistic regression, hypertension (odds ratio 4.79, 95% confidence interval 1.44–15.9) and dyslipidemia (odds ratio 11.6, 95% confidence interval 5.65–23.9) increased risk for possible NAFLD but not income:poverty ratio, hours spent on computer use, or added sugars. DISCUSSION: Although HBV prevalence has decreased in recent years among US children and adolescents, HCV and possible NAFLD have increased. Public health efforts must seek further understanding of the driving factors of this increase so that age-appropriate interventions can be developed and implemented.

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Advances in diagnosis of chronic liver diseases in pediatric patients

Cited by 9 publications

References 52 publications

Comparative study between liver biopsy and non-invasive biomarkers in assessment of hepatic fibrosis in children with chronic liver diseases

Comparative study between liver biopsy and non-invasive biomarkers in assessment of hepatic fibrosis in children with chronic liver diseases

Etiology in Children Presented With Chronic Liver Disease in a Tertiary Care Hospital

The Changing Epidemiology of Liver Disease Among US Children and Adolescents From 1999 to 2016

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