LAL-D can be misdiagnosed as other liver diseases such as NAFLD, Wilson disease, other storage disorders, infectious or immune conditions, and more1,2


All patient images are hypothetical

Physician with child

NASPGHAN recommends

ruling out metabolic disorders (such as LAL-D), medications, dietary causes, and infections when evaluating children for NAFLD3

Lady looking forward

AASLD recommends

ruling out alternative causes of microvesicular steatosis like LAL-D when evaluating adults for NAFLD4

↑ALT + ↑LDL-C should prompt testing for LAL-D5


Image adapted from Corey KE, et al. J Pediatr Gastroenterol Nutr. 2015;60(3):360-367 and
Corey KE, et al. Aliment Pharmacol Ther. 2015;41(3):301-309

Percentages represent baseline characteristics of three separate studies in different patient populations; direct comparisons and implications of different management strategies cannot be made.

Liver disease progression may be more rapid in LAL-D than in NAFLD/NASH

Time to liver progression

Note: Separate studies and distinct patient populations are shown; direct comparisons cannot be made.


NOTE: These studies represent individual publications using different patient populations and follow-up time. Data are not directly comparable. 

a95% CI, 9.1-50.0 years.
bMost of the histologic assessment of fibrosis staging was done using Brunt’s classification. In Brunt’s classification: score 0 is the absence of fibrosis, score 1 is perisinusoidal/pericellular fibrosis, score 2  is periportal fibrosis, score 3 is bridging fibrosis, score 4 is cirrhosis.11
c95% CI, 4.8-14.3 years.

Abbreviations: AASLD, American Association for the Study of Liver Diseases; ALT, alanine aminotransferase; LAL-D, lysosomal acid lipase deficiency; LDL-C, low-density lipoprotein cholesterol; LLMs, lipid-lowering medications; NAFLD, nonalchoholic fatty liver disease; NASH, nonalchoholic steatohepatitis; NASPGHAN, North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

References: 1. Reiner Ž, et al. Atherosclerosis. 2014;235(1):21-30. 2. Manns MP, et al. J Hepatol. 2015;62(1 suppl):S100-S111. 3. Vos MB, et al. J Pediatr Gastroenterol Nutr. 2017;64(2):319-334. 4. Chalasani N, et al. Hepatology. 2018;67(1):328-357. 5. Burton BK, et al. J Pediatr Gastroenterol Nutr. 2015;61(6):619-625. 6. Corey KE, et al. J Pediatr Gastroenterol Nutr. 2015;60(3):360-367. 7. Corey KE, et al. Aliment Pharmacol Ther. 2015;41(3):301-309. 8. Data on File, Alexion Pharmaceuticals. 9. Burton BK, et al. Curr Med Res Opin. 2017;33(7):1211-1214. 10. Singh S, et. al. Clin Gastroenterol Hepatol. 2015;13(4):643-654.e1-e9. 11. Santiago-Rolón A, et al. P R Health Sci J. 2015;34(4):189-194. 12. Lukacs Z, et al. Clinica Chimica Acta. 2017;471:201-205.

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