Konstantinos Kalliamvakos

konstantinos.kalliamvakos@cambio.se

Cambio CDS

To assist in the diagnosis of steatohepatitis, based on histology, in NAFLD patients.

<p>Use to diagnose steatohepatitis, based on histology, in NAFLD patients. The score is calculated by adding the points of the idividual criteria:</p><table><thead><tr style="text-align: left;"><th>Variable</th><th></th><th>Points</th></tr></thead><tbody><tr style="text-align: left;"><td rowspan="4">Steatosis (grade): low- to medium-power evaluation of parenchymal involvement by steatosis</td><td>&lt;5%</td><td>0</td></tr><tr style="text-align: left;"><td>5-33%</td><td>1</td></tr><tr style="text-align: left;"><td>34-66%</td><td>2</td></tr><tr style="text-align: left;"><td>&gt;66%</td><td>3</td></tr><tr style="text-align: left;"><td rowspan="4">Inflammation (lobular): overall assessment of all inflammatory foci</td><td>No foci</td><td>0</td></tr><tr style="text-align: left;"><td>1 focus per 200× field</td><td>1</td></tr><tr style="text-align: left;"><td>2‐4 foci per 200× field</td><td>2</td></tr><tr style="text-align: left;"><td>&gt;4 foci per 200× field</td><td>3</td></tr><tr style="text-align: left;"><td rowspan="3">Liver cell injury (ballooning)</td><td>None</td><td>0</td></tr><tr style="text-align: left;"><td>Few balloon cells</td><td>1</td></tr><tr style="text-align: left;"><td>Many cells/prominent ballooning</td><td>2</td></tr></tbody></table><p>Interpretation:</p><table><thead><tr style="text-align: left;"><th>NAFLD Activity Score</th><th>Activity*</th></tr></thead><tbody><tr style="text-align: left;"><td>0</td><td>No activity</td></tr><tr style="text-align: left;"><td>1-2</td><td>Mild activity</td></tr><tr style="text-align: left;"><td>3-5</td><td>Moderate activity</td></tr><tr style="text-align: left;"><td>6-8</td><td>Marked activity</td></tr></tbody></table><p>*Note: the score correlates with steatohepatitis diagnosis, but should not be used to definitively diagnose NASH.</p>

1. Kleiner DE, Brunt EM, Van natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313-21. 2. Brunt EM, Kleiner DE, Wilson LA, Belt P, Neuschwander-tetri BA. Nonalcoholic fatty liver disease (NAFLD) activity score and the histopathologic diagnosis in NAFLD: distinct clinicopathologic meanings. Hepatology. 2011;53(3):810-20. 3. Kleiner DE, Brunt EM, Wilson LA, et al. Association of Histologic Disease Activity With Progression of Nonalcoholic Fatty Liver Disease. JAMA Netw Open. 2019;2(10):e1912565.

EVALUATION.nafld_activity_score.v0