Evidence map›Paper›PMID 41821805›Full record

ArticleFrontiers in gastroenterology (Lausanne, Switzerland)2023

Cryptogenic chronic hepatitis: looking for an ideal diagnostic algorithm.

Guilherme Grossi Lopes Cançado, Aline Coelho Rocha Candolo, Mateus Jorge Nardelli, Patricia Momoyo Zitelli, Daniel Ferraz de Campos Mazo, Claudia Pinto Oliveira, Marlone Cunha-Silva, Raquel Dias Greca, Roberta Chaves Araújo, Amanda Sacha Paulino Tolentino Alustau and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in gastroenterology (Lausanne, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Guilherme Grossi Lopes CançadoInstituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Aline Coelho Rocha CandoloDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Mateus Jorge NardelliInstituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Patricia Momoyo ZitelliDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Daniel Ferraz de Campos MazoDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Claudia Pinto OliveiraDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Marlone Cunha-SilvaDivision of Gastroenterology (Gastrocentro), School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.
Raquel Dias GrecaDivision of Gastroenterology (Gastrocentro), School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil.
Roberta Chaves AraújoGastroenterology Division, Ribeirão Preto Medical School, Universidade de São Paulo - Ribeirão Preto, Ribeirão Preto, Brazil.
Amanda Sacha Paulino Tolentino AlustauGastroenterology Division, Ribeirão Preto Medical School, Universidade de São Paulo - Ribeirão Preto, Ribeirão Preto, Brazil.
Cláudia Alves CoutoInstituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Gabriel Rezende de Lima RoqueDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Alberto Queiroz FariasDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Flair José CarrilhoDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Mário Guimarães PessôaDivision of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Cryptogenic chronic hepatitis is a growing cause of liver transplants, affecting 5%-15% of patients with chronic liver diseases. This study aimed to identify underlying causes of cryptogenic liver disease in a Brazilian cohort and propose a new diagnostic algorithm, including investigation for metabolic-dysfunction-associated fatty liver disease (MAFLD) and lysosomal acid lipase deficiency (LAL-D). Methods: A retrospective analysis was conducted on 326 patients with presumed cryptogenic hepatitis. Results: Using Czaja's algorithm, non-alcoholic fatty liver disease was diagnosed in 21.3% of patients, while alpha-1 antitrypsin deficiency, alcoholic liver disease, autoimmune hepatitis, hemochromatosis, biliary-related hepatitis, viral hepatitis, Budd-Chiari syndrome, glycogenosis, drug-induced liver injury, and Wilson's disease were diagnosed in smaller proportions (< 3.5% each). LAL-D was found in 1% of patients, and 53.6% of patients remained with cryptogenic hepatitis. The etiology of the liver disease in a subset of patients undergoing liver transplantation was updated Conclusion: One-third of patients with initially presumed cryptogenic liver disease were diagnosed with MAFLD. LAL-D should be considered in patients with chronic liver disease of unknown etiology. The updated diagnostic algorithm proposed in this study could improve diagnostic accuracy and aid in the management of patients with cryptogenic hepatitis.

Indexed as

algorithmcryptogenic cirrhosiscryptogenic hepatitisdiagnosismetabolic associated fatty liver diseasenon-alcoholic fatty liver disease

Identifiers

PMID41821805
PMCPMC12952394

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.