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Chief
Editor -
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Abyad
MD, MPH, MBA, AGSF, AFCHSE
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medi+WORLD International
AUSTRALIA
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publishermwi@gmail.com
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APRI
and FIB-4 - a simple predictor of
fibrosis in NAFLD/NASH at the primary
care level - A case report
Koshy Mathew
1, Shaikha Abdulla Shaheen 2,
Prince Christopher Rajkumar Honest
2, Fathima Shezoon Mohideen 3
(1) Consultant in Internal Medicine,
Primary Health Care Corporation,
Qatar
(2) Consultant in Family Medicine,
Primary Health Care Corporation,
Qatar
(3) Senior Consultant in Family
Medicine, Primary Health Care Corporation,
Qatar
Corresponding author
:Dr Koshy Mathew, Consultant in
Internal Medicine,
Primary Health Care Corporation,
Qatar
Email: kmathew@phcc.gov.qa
Received: June 2023. Accepted:
July 2023; Published: August 1,
2023.Citation: Koshy M, et al. APRI
and FIB-4 - a simple predictor of
fibrosis in NAFLD/NASH at the primary
care level - A case report. World
Family Medicine. August 2023; 21(7):
56-59 DOI: 10.5742/MEWFM.2023.95256144
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Abstract
The importance of simple investigations
like platelets, AST (Aspartate
aminotransferase) and ALT
(Alanine aminotransferase)
when managing patients with
NAFLD (non-alcoholic fatty
liver disease) and NASH (non-alcoholic
steatohepatitis) in primary
care should not be overlooked,
as this would predict the
progression to fibrosis and
cirrhosis. A better control
of diabetes, metabolic syndrome
and the reduction of bodyweight
at an early stage when the
APRI (AST to Platelet ratio
index) and/or FIB-4 score
is significant, would have
delayed/aborted the progression
to fibrosis and cirrhosis
is highlighted by this case
report. Physicians in primary
care should be aware of the
significance of low platelet
count and high AST (a ‘red
flag’) in a case of NAFLD
and NASH, and should provide
intense control of diabetes,
obesity and metabolic syndrome
followed by a referral to
a gastroenterologist/hepatologist
at an early stage.
Key
words:
Primary Care, General Practice,
NASH, NAFLD, FIB-4, APRI,
Red flag, low platelet, cirrhosis,
primary prevention
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