cliot (version 1.0.0)

nafcs_score: North American Familial Chylomicronemia Score (NAFCS)

Description

Calculates the NAFCS (derived from the Moulin FCS Score) to estimate the likelihood of Familial Chylomicronemia Syndrome (FCS) in patients with severe hypertriglyceridemia. The score assesses clinical history, response to treatment, and the absence of secondary factors to differentiate FCS from Multifactorial Chylomicronemia Syndrome (MCS).

Usage

nafcs_score(fasting_tg_mg_dl, history_pancreatitis, unexplained_abdominal_pain,
            secondary_factors_present, age_onset_lt_40, poor_response_treatment,
            tg_units = "mg/dL")

Value

A list containing:

NAFCS_Score

The calculated total score (Range 0-9).

Interpretation

Diagnostic likelihood (Unlikely vs. Very Likely).

Arguments

fasting_tg_mg_dl

Numeric. Fasting triglyceride level. Note: The score requires a history of at least three consecutive fasting triglyceride levels > 885 mg/dL (10 mmol/L). This input should be the highest recorded level. 10-20 mmol/L (885-1770 mg/dL): +1 point. >20 mmol/L (>1770 mg/dL): +3 points.

history_pancreatitis

Numeric (0 or 1). History of pancreatitis. (1 = Yes, +1 point).

unexplained_abdominal_pain

Numeric (0 or 1). History of recurrent, unexplained abdominal pain. (1 = Yes, +1 point).

secondary_factors_present

Numeric (0 or 1). Presence of secondary factors for hypertriglyceridemia (e.g., BMI > 30, diabetes, alcohol use, pregnancy, specific medications). (0 = No secondary factors present, +2 points; 1 = Secondary factors present, 0 points).

age_onset_lt_40

Numeric (0 or 1). Age at diagnosis of hypertriglyceridemia < 40 years. (1 = Yes, +1 point).

poor_response_treatment

Numeric (0 or 1). History of poor response (<20% reduction) to standard lipid-lowering therapy (fibrates/statins). (1 = Yes, +1 point).

tg_units

String. Units for triglyceride input. Options: "mg/dL" (default) or "mmol/L".

References

Moulin P, Dufour R, Averna M, et al. Identification and diagnosis of patients with familial chylomicronemia syndrome (FCS): Expert panel recommendations and proposal of an "FCS score". Atherosclerosis. 2018;275:265-272. doi:10.1016/j.atherosclerosis.2018.06.814 Paquette M, Ahmed Z, Hegele RA, Baass A. The Familial Chylomicronemia Syndrome Score: Validation of a Clinical Tool for the Diagnosis of Familial Chylomicronemia Syndrome. J Clin Lipidol. 2019.

Examples

# Example 1: High Likelihood
# TG 2000 mg/dL (+3), Pancreatitis (+1), No secondary factors (+2),
# Age <40 (+1), Poor response (+1), Pain (0)
# Score = 3 + 1 + 2 + 1 + 1 = 8 (Borderline/High)
nafcs_score(2000, 1, 0, 0, 1, 1)

# Example 2: Low Likelihood
# TG 900 mg/dL (+1), No pancreatitis, Secondary factors (Diabetes) present (0),
# Age >40 (0), Good response (0)
# Score = 1
nafcs_score(900, 0, 0, 1, 0, 0)