A practical clinical approach to liver fibrosis.
- Author:
Rahul KUMAR
1
;
Eng Kiong TEO
1
;
Choon How HOW
2
;
Teck Yee WONG
3
;
Tiing Leong ANG
1
Author Information
- Publication Type:Journal Article
- Keywords: chronic liver disease; fibrosis assessment; noninvasive composite scores
- MeSH: Alanine Transaminase; blood; Aspartate Aminotransferases; blood; Decision Making; End Stage Liver Disease; complications; diagnosis; therapy; Hepatitis B; complications; Humans; Liver; pathology; Liver Cirrhosis; complications; diagnosis; therapy; Non-alcoholic Fatty Liver Disease; complications; diagnosis; therapy; Prognosis; Referral and Consultation; Treatment Outcome
- From:Singapore medical journal 2018;59(12):628-633
- CountrySingapore
- Language:English
- Abstract: Liver fibrosis is a slow, insidious process involving accumulation of extracellular matrix protein in the liver. The stage of liver fibrosis in chronic liver disease (CLD) determines overall morbidity and mortality; the higher the stage, the worse the prognosis. Noninvasive composite scores can be used to determine whether patients with CLD have significant or advanced fibrosis. Patients with low composite scores can be safely followed up in primary care with periodic reassessment. Those with higher scores should be referred to a specialist. As the epidemic of diabetes mellitus, obesity and non-alcoholic fatty liver diseases is rising, CLD is becoming more prevalent. Easy-to-use fibrosis assessment composite scores can identify patients with minimal or advanced fibrosis, and should be an integral part of decision-making. Patients with cirrhosis, high composite scores, chronic hepatitis B with elevated alanine aminotransferase and aspartate aminotransferase, or deranged liver panel of uncertain aetiology should be referred to a specialist.
