Figure 4.
Hemochromatosis staging. Predicting the presence of ALF is important since it increases the risk of HCC and requires adequate surveillance. Noninvasive tools include APRI (aspartate aminotransferase-to-platelet ratio index) and FIB-4 (patient age, platelet count, aspartate aminotransferase, and alanine aminotransferase) scores, and FibroScan (measuring liver stiffness through transient elastography).4,8,23 A liver biopsy is rarely performed in uncertain cases. Extrahepatic complications should be properly investigated in patients with ascertained or likely ALF. The endocrine profile should include follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, or estrogens, looking at possible hypogonadotropic hypogonadism, especially in juvenile forms. CBC, complete blood count; DEXA, dual-energy X-ray absorptiometry, measuring bone mineral density; ECG, electrocardiogram.

Hemochromatosis staging. Predicting the presence of ALF is important since it increases the risk of HCC and requires adequate surveillance. Noninvasive tools include APRI (aspartate aminotransferase-to-platelet ratio index) and FIB-4 (patient age, platelet count, aspartate aminotransferase, and alanine aminotransferase) scores, and FibroScan (measuring liver stiffness through transient elastography).4,8,23 A liver biopsy is rarely performed in uncertain cases. Extrahepatic complications should be properly investigated in patients with ascertained or likely ALF. The endocrine profile should include follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, or estrogens, looking at possible hypogonadotropic hypogonadism, especially in juvenile forms. CBC, complete blood count; DEXA, dual-energy X-ray absorptiometry, measuring bone mineral density; ECG, electrocardiogram.

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