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CPE-005 · Fibrosis risk
LV-FIB-04: ALT normalizing with falling platelets
ALT normalizing with falling platelets. Evaluates steatotic liver disease known.
Active rulePriority 3Liver engine v1.0.0
Condition
- steatotic liver disease known
- ALT falling or newly normal
- platelets falling
What it reports
- Caution: falling ALT with falling platelets can mean advancing fibrosis, not improvement
Recommended next steps (for physician review)
- Recalculate FIB-4 and consider elastography; do not reassure on ALT alone
Diagnostic boundary
- A trend flag; it does not stage fibrosis.
Evidence
- EV-AASLD-2023Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835.Supports: FIB-4 first for risk stratification; thresholds <1.3 and >2.67; elastography 8 and 12 kPa; ELF 7.7 and 9.8 ALT upper limits near 29–33 U/L (men) and 19–25 U/L (women) Cardiovascular risk is the leading cause of death in MASLD
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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