Evidence map›Paper›PMID 41809474›Full record

ArticleWorld journal of hepatology2026

Diagnostic challenges of clinically significant portal hypertension in geriatric metabolic dysfunction-associated fatty liver disease: A case report.

Femmy Nurul Akbar, Nikko Darnindro, Annisa Ayu Wardhani, Safira Rosiana Choirida, Shafa Nada Saphira, Griffith Ismed, Ida Ayu Made Kshanti, Syifa Mustika, Hari Hendarto

Abstract readCase Reports
In one paragraph

Article in World journal of hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Femmy Nurul AkbarDepartment of Internal Medicine, Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah Jakarta, South Tangerang 15412, Banten, Indonesia. femmy.nurul@uinjkt.ac.id.
Nikko DarnindroDepartment of Internal Medicine, Fatmawati General Hospital, South Jakarta 12430, Jakarta, Indonesia.
Annisa Ayu WardhaniDepartment of Internal Medicine, Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah Jakarta, South Tangerang 15412, Banten, Indonesia.
Safira Rosiana ChoiridaDepartment of Internal Medicine, Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah Jakarta, South Tangerang 15412, Banten, Indonesia.
Shafa Nada SaphiraFaculty of Medicine, Universitas Trisakti, Jakarta 11620, Jakarta, Indonesia.
Griffith IsmedFaculty of Medicine, Universitas Trisakti, Jakarta 11620, Jakarta, Indonesia.
Ida Ayu Made KshantiDepartment of Internal Medicine, Fatmawati General Hospital, South Jakarta 12430, Jakarta, Indonesia.
Syifa MustikaDepartment of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Jawa Timur, Indonesia.
Hari HendartoDepartment of Internal Medicine, Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah Jakarta, South Tangerang 15412, Banten, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated fatty liver disease (MAFLD) may progress to cirrhosis and lead to serious complications. Lipid accumulation, hepatocellular ballooning, and sinusoidal endothelial dysfunction increase intrahepatic vascular resistance, resulting in early clinically significant portal hypertension (CSPH). Although hepatic venous pressure gradient (HVPG) remains the gold standard, decompensated cirrhosis may yield deceptively low values. Transient elastography and platelet count provide supportive diagnostic evidence, yet obesity can overestimate disease severity. This report highlights the diagnostic challenge of CSPH, especially MAFLD in geriatric patients. CASE SUMMARY: A 78-year-old woman with class I obesity, type 2 diabetes mellitus, and dyslipidemia presented with hematemesis and melena for a three-day period. A prior computed tomography scan revealed moderate diffuse hepatic steatosis, splenic vein dilatation, and splenomegaly. On admission, she presented with pallor, epigastric tenderness, splenomegaly, and mild ascites. Laboratory findings showed anemia, thrombocytopenia, hypoalbuminemia, and hyperglycemia. Abdominal ultrasound confirmed chronic liver disease with splenomegaly. Esophagogastroduodenoscopy demonstrated grade II-III esophageal varices and portal hypertensive gastropathy. Noninvasive fibrosis assessments (non-alcoholic fatty liver disease fibrosis score, aspartate transaminase-to-platelet ratio index, fibrosis-4 index, and FibroScan: E = 28 kPa, controlled attenuation parameter = 191 dB/m) indicated advanced hepatic fibrosis. HVPG measurement was not performed, however due to the Baveno VII criteria (transient elastography ≥ 25 kPa and platelet count < 150 × 10

conclusionEarly and precise evaluation of CSPH in geriatric MAFLD requires an integrated clinical assessment to optimize diagnosis, management, and improve outcomes.

Indexed as

Case reportClinically significant portal hypertensionGeriatric patientsHepatic fibrosis assessmentLiver cirrhosisMetabolic dysfunction-associated fatty liver disease

Identifiers

PMID41809474
PMCPMC12968692

What Socratic holds

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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 Socratic graph.